Syphilis is a systemic bacterial infection, chronic, curable and exclusive to humans. When left
untreated or treated inappropriately, it progresses to more severe stages and can affect various
organs and systems of the human body. Its main route of transmission is through sexual
contact in unprotected relationships. When left untreated or treated inadequately, vertical
transmission of congenital syphilis from the pregnant woman to the fetus may occur. The
objective of this study was to characterize the epidemiological scenario of maternal and
congenital syphilis in the State of Amapá, Brazilian Amazon, from 2018 to 2023. It is an
epidemiological, descriptive, documentary research with a quantitative approach. The
significance analysis of differences between the years under study was carried out using
Pearson's Chi-square test for k independent samples and the Likelihood Ratio Test,
considering a significance level of 5%. To calculate the incidence rates of MS and CS, the
formula was used (number of cases divided by live births multiplied by 1,000). The data
revealed that during the study period, 1,137 cases of maternal syphilis and 393 cases of
congenital syphilis were reported, of which 92% of newborns were classified as alive and 2%
died from congenital syphilis. Regarding epidemiological and clinical characteristics, the
majority of mothers were aged between 21-30 years, had low education, were mixed race and
worked in the informal sector. 68% received prenatal care; 80% presented positive VDRL
during prenatal care; 54% were diagnosed with syphilis prenatally; while 44% at the time of
delivery/curettage; 83% did not undergo adequate treatment and 87% of partners were not
treated at the same time as the pregnant woman. Regarding the epidemiological and clinical
characteristics of newborns, the highest number of positive diagnoses occurred at an age of
less than 7 days; 53% were female; 97% had reactive VDRL; 89% with asymptomatic clinical
diagnosis; 82% were treated with Crystalline Penicillin G 100,000 to 150,000 IU/Kg/Day - 10
Days. It is concluded that despite government efforts to control and eradicate maternal and
congenital syphilis, the pathology still persists with high prevalence rates in the State of
Amapá, as evidenced by this research. Therefore, it is necessary to intensify screening actions
for pregnant women so that they start prenatal care as early as possible, raise awareness
among partners so that they can participate effectively in prenatal care, and train health teams
so that they can offer a quality clinical management in the diagnosis, monitoring and
treatment of maternal and congenital syphilis.
Keywords: Syphilis; Congenital syphilis; Epidemiology; Amapá.

Bariatric surgery is the most effective method against obesity and its short-term
complications, causing significant improvement in the patient’s metabolic rates, leading
to an improvement in quality of life. The study aimed to outline the epidemiological
profile of patients who underwent bariatric surgery in the city of Macapá in the state of
Amapá. This study is characterized as descriptive, quantitative and cross-sectional
with data collection through online questionnaire platform on patients who underwent
bariatric surgery in the public or private health system in the state of Amapá. It was
possible to observe that the profile of the patients was of married women with children,
in the teaching profession, aged 40-49 years, self-declared mixed race, with a
postgraduate degree, with Class III Obesity, having undergone gastric bypass surgery,
with one year after surgery, presenting no difficulties in carrying out the phases of the
postoperative protocol, having hepatic steatosis as the main associated comorbidity.
Sex and age group were the variables that showed a significant association with
comorbidity (p = 0,000), in both cases. Based on the data presented, it was possible
to verify that the profile of patients who had bariatric surgery contradicts what is
proposed in the literature.

Keywords: Obesity. Morbid Obesity. Bariatric Surgery.

Introduction: the covid-19 pandemic caused chaos in public health in Brazil and
around the world, also resulting in losses to the economy. Emergency actions
highlighted the importance of continuing the service provided by banking professionals,
amid the risk of greater exposure and illness. Objective: investigate the occurence of
covid-19 among professionals in the banking sector in the Metropolitan Region of

Macapá (RMM), in the state of Amapá. Materials and methods: this is a cross-
sectional analytical study, carried out at the Financial Sector Workers Union of Amapá

(Sintraf-AP), as well as public and private banking institutions distributed in the RMM.
96 professionals working in the banking sector were interviewed, from June to August
2021. A structured questionnaire was applied on questions pertinent to
sociodemographic, clinical and work characteristics and, subsequently, RT-qPCR
samples were collected. The information was organized in a Microsoft Excel 2019
database and then statistical analysis was performed using the Statistical Package for
the Social Sciences (SPSS) version 25.0. Quantitative variables were characterized
by absolute and relative frequencies (in%) and Pearson's Chi-Square Test was
performed, considering a significance level of 5% (p<0,05). This research was
conducted as part of the project “‘Randomized’ covid-19 testing: an alternative to mass
testing to monitor SARS-CoV-2 infections in the population of Amapá, Brazil”. Results:
the percentage of positive people, through the RT-qPCR test (1%), was similar to that
of the RMM population (0,96%), however, when observing the data referring to the
percentage of self-declared people diagnosed with covid- 19 (78,1%), at the time of
collection, was significantly higher than this population (13,6%). The majority of
professionals diagnosed with the disease were aged between 31 and 50 years
(66,67%), female (50,67%), self-declared mixed race (62,66%), with a family income
of two to five minimum wages. (42,67%), residents of the municipality of Macapá (56%)
and with higher education (56%). They lived in masonry housing (93,33%), with access
to running water (58,67%) and private transportation (97,34%). And, there is also a low
presence of family members with comorbidities living with them. The presence of
symptoms common to Covid-19 among those investigated was low, not reflecting the
number of diagnoses. There was a predominance of the RT-qPCR test (69,3%),
individuals who had recent contact with a person diagnosed with the disease (76%),
had at least one dose of the vaccine (92%), were not part of the risk group (85,34%)
and did not even live with a person in the risk group (57,34%). In relation to work
activities, it is noted that the majority of those diagnosed are linked to a public institution
(58,7%), working directly with the public (45,07%), with a high frequency of
consultations (45,33%) and had a positive diagnosis during the performance of their
duties (94,7%). The association test indicated that carrying out work activities was a
risk factor for participants for Covid-19 contamination. Initial considerations: the
scope of the data highlights the epidemiological scenario of covid-19 among banking
professionals, being fundamental in helping public health actions and policies to
combat the pandemic, mainly for the public investigated.
Keywords: Covid-19; Bank officer; Risk of illness.

Breast cancer treatment has progressively improved with advances in endocrine therapy, early detection and surgical techniques that advocate breast conservation. Despite advances in breast cancer treatment, patients treated for breast cancer have comorbidities that impact their quality of life. Therefore, the objective of the present study was to investigate the level of physical activity in women treated for breast cancer. This is an observational study, the sample consisted of 61 women, evaluated by a first researcher responsible for sociodemographic assessment and data related to treatment and BMI, and by a second evaluator blind to the treatment who was responsible for evaluating activity. physical and quality of life. To identify the impact of adjuvant treatment, the volunteers were divided into two groups, one that underwent adjuvant treatment (chemotherapy + radiotherapy) (n = 31) and the group that underwent surgery only (n = 30). Data analysis was performed descriptively and the t-test for independent measurements was used to compare groups and the homogeneity of variance was used using Levene's test. The results of the present study demonstrate that women in the group that underwent adjuvant treatment presented a reduction in habitual physical activity of 7.34 (SD= 0.69) and presented a higher Body Mass Index of 31.03 (SD=0.52) when compared to the group who did not undergo adjuvant treatment, in relation to quality of life between the groups with and without adjuvant treatment, show that there is no statistical difference in relation to the quality of life of the sample. Therefore, the present study identified that women who underwent adjuvant treatment have a low level of physical activity compared to survivors who only underwent surgical treatment, as well as a high BMI compared to the group without adjuvant treatment and directs that studies continue to monitor populations like this to that the literature advances in incisive guidelines to help multidisciplinary teams. Key words: Breast cancer; Level of physical activity; Physiotherapy in cancer treatment; Adjunctive treatment.

Introduction: Sarcopenia and frailty are conditions that directly affect the lives of elderly people and their associations with oral health variables have been discussed in the literature. Despite this, there is a scarcity of Brazilian studies mentioning this topic. Objective: To analyze the association between oral health status and conditions of physical frailty and sarcopenia in elderly people living in the community. Methods: This is an observational cross-sectional study, carried out with elderly people from the community living in the city of Macapá, in the state of Amapá. Oral health variables were obtained from a structured form. Frailty was operationalized based on the phenotype proposed by Fried et al.; and sarcopenia according to the EWGSOP 2 consensus. Results: Of the 360 elderly people (71.3±7.03 years) evaluated, the majority were male (65%). The prevalence of elderly people with sarcopenia corresponded to 7.8% (n=28). Non-frail elderly represented 27.2%, while pre-frail 55% and frail 17.8%. Regarding oral health, the average number of healthy teeth was 4.81±5.29 and missing teeth 26.69±6.20. 36.7% used dental prostheses, the majority of elderly people needed prostheses. The largest percentage of elderly people classified the health of their teeth and gums as good, 38.3% and 35.2% as good; In the general classification of oral health, 38.3% considered it to be bad and 28% as fair. Conclusion: No statistically significant differences were observed between the frailty conditions, sarcopenia and oral health variables. Keywords: Oral Health. Sarcopenia. Fragility

ABSTRACT Background: To compare smartphone-based measurements of static balance control and mobility of elderly population with and without type 2 diabetes mellitus (DM2). Methods: The present cross-sectional study investigated 73 participants grouped in a control group (n = 36) and a DM2 group (n = 37). Smartphone’s built in inertial sensors were used to record inertial changes of the participants during static balance and mobility (Timed Up and Go test – TUG) tasks. The inertial variations as a function of the time were analyzed and compared between groups. Results: Both groups were matched in age, body mass index, male-female proportion, but DM2 group had significant larger fasting glucose than control group. Additionally, DM2 group had worst static balance control with open and closed eyes than the controls (p < 0.05) as well as they also had longer duration to execute the different events of the mobility test than the controls (p < 0.05). Conclusion: DM2 patients had decline of motor functions compared to controls and the use of bult-in sensors of smartphones was feasible to identify these functional impairments. The easy access of smartphones could be improving the screening of functional impairments in DM2 patients.. Keywords: Diabetes; Balance Control; Mobility; Inertial Sensors; Smartphone

Introduction: Over the years, environmental contamination has generated negative impacts and, consequently, the imminent risk of poisoning human populations. The riverside community Vila de Cassiporé, which resides near the bank of the Cassiporé river, may be vulnerable to the presence of different types of contaminants deposited in the environment. Objective: To investigate traces of environmental contaminants (arsenic, cadmium, lead, copper and mercury) in water, fish and human tissue samples that pose a risk to the health of residents on the banks of the Cassiporé River, in the State of Amapá. Material and methods: This is a descriptive cross-sectional study, in which the technical reports provided by the co-participating institution were analyzed. Qualitative variables were characterized by absolute and relative frequencies, and quantitative variables by descriptive measures minimum, maximum, mean and standard deviation. The study was submitted and approved by the Research Ethics Committee (CEP). Results: Most residents of the region are aged between 18-35 years, female, with low education, blood pressure classified as stage 2 hypertension and use agriculture as a professional activity. Water for consumption is taken from common wells and treated with sodium hypochlorite, there is no control over garbage disposal and they carry out their needs in a private pit with a septic tank. When analyzing the water and hair samples, the presence of a level above the permitted level for mercury and, in the muscle tissue of the fish, for lead was identified. The levels of mercury shown in water samples and, mainly, in hair, are bioindicators of environmental contamination by this metal, with the need to have its presence tested in the muscle tissue of fish, given the frequent consumption of this food by residents Of region. Final considerations: The study approaches discussions about environmental contaminants, their risks to human health and the need for public policies that identify and meet the needs of residents in the region. It is suggested the adoption of measures, in order to inform and prevent the dangers to which they may be submitted; and, also, longitudinal studies that allow the identification of these and other types of contaminants on the health of residents. 

O treinamento com a restrição do fluxo sanguíneo (RFS) é cada vez mais utilizado na reabilitação clínica de distúrbios musculoesqueléticos, mas ainda há muita incerteza sobre quais parâmetros utilizar referente à pressão de restrição, combinação com outras terapias e para quais distúrbios musculoesqueléticos a técnica pode ser mais efetiva. Portanto, o objetivo desta revisão sistemática é comparar a efetividade das diferentes metodologias de uso da RFS na reabilitação dos distúrbios musculoesqueléticos. Para isso, foram realizadas buscas independentes por dois revisores de estudos indexados nas principais bases de dados; além de fontes de literatura cinzenta e nas referências bibliográficas dos estudos incluídos na revisão. Foram considerados elegíveis ensaios clínicos com grupo paralelo que testaram a eficácia do treinamento com RFS em indivíduos com idade igual, ou maior de18 anos, por no mínimo três semanas. Foram extraídos dados referentes as características dos pacientes incluídos, delineamento do estudo, método de aplicação da RFS e desfechos de dor, força muscular e eventos adversos, considerados como desfechos primários; além da capacidade funcional, desconforto, capacidade física global e qualidade de vida, compondo os desfechos secundários. O risco de viés dos estudos foi avaliado por meio da escala Physiotherapy Evidence Database (PEDro) e qualquer discordância durante o processo de seleção, extração e avaliação do risco de viés foi decidido por um terceiro revisor. Foram encontrados 6.927 registros nas bases de dados selecionadas. Após triagem, 191 foram elegíveis para a leitura na integra e 31 incluídos na revisão. O nível de certeza da evidência variou de baixa a muito baixa, indicando que a RFS combinada com exercícios resistidos de baixa intensidade (ERBI) em comparação aos exercícios resistidos de alta/moderada intensidade (ERAI/ERMI), foram superiores para o desconforto durante as sessões (diferença média padronizada [DMP] -1.84, IC 95% -2,33 a - 1,34) e qualidade de vida (DMP 1,01 IC 95% 0,19 a 1,82). A adição da RFS no ERBI foi superior ao ERBI isolada para força de extensores do joelho (DMP 0,91, IC 95% 0,46 a 1,35) e volume muscular de membros inferiores (DMP 0,66 IC 95% 0,1 a 2,21). Da mesma forma, a adição da RFS ao protocolo de reabilitação convencional (RC) aumentou a capacidade funcional (DMP 2,03 IC 95% 1,15 a 2,92) e volume muscular de membros inferiores comparada a RC isolada (DMP 4,27 IC 95% 1,35 a 7,19). O risco de eventos adversos foi similar para os grupos testaram a RFS comparada aos com ERBI e ERAI/ERMI . Para os demais desfechos analisados, não houve diferença entre os protocolos utilizados. De forma geral, a RFS combinada a ERBI é comparável ao treinamento de ERAI/ERMI com a vantagem de ser mais confortável e promover discreto aumento na qualidade vida. Além disso, a adição da RFS ao ERBI foi superior para o ganho de força de extensores de joelho comparada a ERBI isolada, e apresentou melhores resultados para a capacidade funcional e volume muscular de membros inferiores quando adicionada a RC.

Chikungunya infections have been a recurring problem in recent years due to a high number of cases in the northern region of Brazil, which is considered endemic and poses a significant challenge to regional public health. The arbovirus caused by the Chikungunya Virus leads to fever, skin lesions, myalgia, pain, and joint inflammation. The objective of this study is to describe the epidemiological profile of patients notified with post-chikungunya infection in the state of Amapá. This is an observational study of a quantitative and cross-sectional nature, conducted with information from retrospectively evaluated Chikungunya Virus patients. The data are derived from records in the notification forms of the State Health Surveillance Coordination of Amapá, using the Disease Notification Information System. Descriptive statistics present frequency data, mean (standard deviations), median, range, and confidence intervals. Inferential analysis will consider the verification of data normality using the Kolmogorov-Smirnov test. A significance level of 5% (p<0.05) and a confidence interval of 95% were considered. The information from this study may support the proposition and implementation of public actions for this population, as well as interventional studies aiming to improve and execute effective therapeutic approaches for this condition. KEYWORDS: Chikungunya fever; Epidemiological profile, Arthralgia, Arthritis.

Introduction: Motor development (DM) interacts with social and environmental aspects, requiring care and incentive actions for a motor profile compatible with chronological age. Through the Social Determinants of Health (DSSs), more specifically, the social and community support network (RASC), it is possible to understand the health conditions of schoolchildren and the health inequalities to which they are exposed and that inhibit or facilitate DM . Objective: To analyze the DSSs and their relationship with the PM of students from the municipal education network of Macapá/AP from the point of view of the RASC. Materials and Method: Analytical cross-sectional study, where 309 schoolchildren aged 10 years old and enrolled in the 5th year of elementary school in the urban teaching network of the city of Macapá/AP were investigated. The Individual Lifestyle Profile Questionnaire, the Socioeconomic Classification Questionnaire of the Brazilian Association of Research Companies and an adaptation of the Social Support Scale for Physical Activity in Adolescents were applied to parents or guardians; and, for students, the Motor Development Scale (EDM), Social Support Scale for Physical Activity in Adolescents and the Physical Activity Questionnaire for Adolescents. For the data relevant to the EDM, the Integrated Child Development System (SIDI) was used, then the information was organized in the Microsoft Excel 2019 program and the statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) program, version 25.0. Qualitative variables were characterized by absolute and relative frequencies and, for quantitative ones, the descriptive measures minimum, maximum, mean and standard deviation were used. For the bivariate inferential analysis, Pearson's chi-square test and Fisher's exact test will be used, considering a significance level of 5% (p<0.05) for a statistically significant association. Prevalence ratios and their respective 95% Confidence Intervals (95%CI) will be calculated. The study was submitted and approved by the Research Ethics Committee (CEP). Initial results: Most students were male (52.8%), with risk of dyspraxia (88.7%) and greater difficulties in the domains that make up the area of perception. They have 1 to 3 siblings (70.6%), live with “father and mother” (57.6%), whose socioeconomic classification predominates strata “D and E” (78%) and lifestyle identified as “negative” (67.3%). The absence of Physical Education classes occurs only in municipal institutions and there is insufficiently active behavior (86.7%) among students. In the perceived support, parents or guardians do not practice physical activity with their children (71.5%) and, in the support provided, there is a lack of projects (64%) and adequate spaces (51.8%) for physical activity, with insecurity (69.9%) being an aspect to be considered. Initial considerations: The DM of the students does not match *Mandatory data for registration in the system. parameters of normality, requiring the adoption of measures aimed at minimizing the risks of praxis. Low socioeconomic status, exposure to a lifestyle that does not favor well-being and quality of life, lack of co-participatory support and difficulty in accessing public policies related to physical activity are social conditions that must be investigated.

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American Cutaneous Leishmaniasis is a neglected zoonotic disease and a
worldwide public health problem that affects the skin and mucous membranes, and can be caused by different
species of the genus Leishmania sp. This pathology has autochthonous cases in all federated units, with the North region representing the highest detection coefficient. In this context, the general objective of this study was to describe and analyze the epidemiological profile of American Cutaneous Leishmaniasis in the state of Amapá from 2008 to 2020, since there are
little evidence in the literature that deal with the theme in this state that has already been maintained with the
second highest coefficient of detection of the disease in the North region. This is an observational epidemiological study of a descriptive nature and an exploratory approach based on reported cases of Tegumentary Leishmaniasis in the National Information System for Notifiable Disease. The disease data were extracted, tabulated and grouped into sociodemographic and clinical-epidemiological variables, later, the distribution percentages were calculated.
and incidence rate of each variable by year of notification. The trend of American Tegumentary Leishmaniasis in Amapá has shown a decline in the incidence rate of the disease in recent years.
six years. The sociodemographic variables showed a profile with the highest percentage distribution
and higher incidence in males, between the ages of 20 and 59, of brown race with incomplete primary schooling, from urban areas. A transmission pattern was identified, in the clinical-epidemiological variables, in the individual's place of residence, diagnosis
by the clinical-laboratory method, cutaneous type clinical form and evolution towards the cure of the disease.
There was an annual trend towards a reduction in reported cases and a consequent decrease in the risk of
exposure to the disease during the analyzed period. The epidemiological profile as a higher risk of
development of American Tegumentary Leishmaniasis in Amapá are men in an economically active phase and with a low level of education who travel to areas of infection due to
the work activity they carry out.
Keywords: Epidemiology; Epidemiological profile; Cutaneous Leishmaniasis; Amapá.

A tuberculose pulmonar é uma doença considerada importante problema de saúde pública, por ser incapacitante, gerando preconceito e estigma. Desta forma, o objetivo geral da pesquisa é: avaliar a qualidade de vida de indivíduos com tuberculose pulmonar que aderem à fase intensiva do esquema básico antiberculose em um Centro de Doenças Tropicais na Amazônia Legal. Quanto aos objetivos específicos: Traçar o perfil epidemiológico dos indivíduos com TBP segundo variáveis socioeconômicas, epidemiológicas e clínicas; Avaliar os aspectos da qualidade de vida dos indivíduos com TBP, a partir dos domínios do Questionário de Qualidade de Vida -SF-36. Analisar a influência dos domínios do SF-36 nas variáveis sociodemográficas dos participantes do estudo. Trata-se de um estudo prospectivo de pacientes com tuberculoses pulmonar em tratamento na fase intensiva. Será utilizado para coleta de dados um formulário socioeconômico, epidemiológico e clínico e a qualidade de vida será avaliada por meio do uso do Questionário de Qualidade de Vida -SF-36. Quanto a análise: Para a apresentação dos dados fez-se uso de estatísticas descritivas com recursos de tabelas de frequências e porcentagens. Para análise inferencial, primeiramente aplicamos o teste de normalidade de Shapiro-Wilk para avaliar a aderência de distribuição normal das variáveis quantitativas. Como as variáveis quantitativas não apresentaram normalidade de dados, fez-se uso de testes não paramétricos para comparação dessas variáveis com dados sociodemográficos e descritivos. O estudo realizado apontou como resultado, que a maioria desta população é do sexo masculino, na faixa-etária de 30-50 anos, declaram-se preto-pardo, residem em casas próprias localizadas na região metropolitana do estado, afirmam serem solteiros-divorciado, auto-dominam-se evangélicos, com situação trabalhista desempregado e ensino fundamental como nível escolaridade referida. Ademais, os domínios apresentaram valores abaixo de 100 na pontuação do Raw Scale do SF-36, com exceção do domínio “Saúde Mental” cuja pontuação média foi de 57.2 ±21.7. Nas menores pontuações destacam-se os domínios “Limitações por Aspectos Físicos” com 12.5 ±32.8 e “Aspectos Emocionais” com 26.7 ±44.2.

Considerada um grave problema de saúde pública, o controle da doença de Chagas ainda é visto como um desafio, especialmente no que diz respeito à forma de transmissão, diagnóstico precoce e ao caráter crônico e incapacitante do agravo. Sob esta ótica, esta pesquisa tem como objetivo: descrever o comportamento epidemiológico da doença de Chagas no Amapá, no período de 2010 a 2020, e as implicações relacionadas ao acesso ao diagnóstico e tratamento do agravo no estado. Trata-se de um estudo de caráter descritivo, exploratório, retrospectivo, com abordagem quantitativa e qualitativa. Coleta de dados realizada por meio de questionário sociodemográfico, epidemiológico e clínico, seguido de entrevista semiestruturada. Os resultados do estudo apontam que o perfil sociodemográfico, epidemiológico e clínico, assim como, as variavéis de acesso aos
serviços de saúde envolvidas no processo de busca pelo diagnóstico e tratamento da doença de Chagas, impactam diretamente no comportamento da doença no estado do Amapá, influenciando na qualidade de vida do paciente e na busca de estratégias para enfrentamento da enfermidade. A análise das narrativas dos entrevistados quanto ao percurso traçado, nos leva a refletir o quanto o sistema público de saúde está fragilizado, visto que a oferta dos serviços ainda está centralizada na atenção especializada, sendo que a atenção primária não está preparada para a identificação da doença, tão pouco a média e alta complexidade estão qualificadas para uma assistência resolutiva e isso faz com que o usuário padeça construindo o seu percurso em busca de resolutividade das suas necessidades em saúde.A identificação do perfil desses usuários nos últimos onze anos contribui para o conhecimento de uma realidade que se faz presente no estado, mas que ainda sim, é pouco discutida e investigada. Contribuindo para o surgimento de estratégias de melhoria no atendimento, principalmente no fortalecimento do sistema de referência e contrarreferência, regulação de consultas e exames, desde que sejam implementadas condutas sistematizadas, elaboração de protocolos com a finalidade de trabalho preventivo e fortalecimento do sistema de vigilância em saúde.

As plantas têm sido utilizadas pelo homem há milhares de anos e continuam tendo o seu valor não apenas nas comunidades tradicionais como também são objetos de estudos interdisciplinares na busca de novos fármacos, haja visto, as observações populares sobre o uso e a eficácia de plantas medicinais contribuem de forma relevante para o desenvolvimento de alternativas terapêuticas. Em virtude disto, têm-se a importância de realizar levantamentos etnobotânicos que podem subsidiar estudos fotoquímicos e etnofarmacológico na busca por fitoterápicos para o tratamento de enfermidades de doenças crônicas. Diante do exposto o objetivo deste trabalho é conhecer as plantas medicinais com finalidade fitoterápica para o tratamento de doenças crônicas, sendo o local de estudo a comunidade quilombola do Curiaú no Estado do Amapá. É um estudo descritivo com abordagem qualitativa-quantitativa, através de um questionário semiestruturado, com participação de ambos os sexos, na faixa etária de idade igual ou maior de 30 anos, objetivando o estabelecimento da relação entre plantas medicinais e sua utilidade de acordo com o costume popular no município de Macapá/AP. Os dados foram tabulados e analisados pelo software estatístico Microsoft Excel for Windows 2010. A análise foi realizada por meio da estatística descritiva (frequência absoluta e relativa) dos dados referentes ao perfil sociodemográfico, para a descrição dos resultados estatísticos, sendo estes considerados relevantes, possibilitou traçar o seguinte perfil socioeconômico: gênero feminino (60,67%), com idade de igual ou maior de 30 anos (72,00%) e da religião católica (66,00%). Desse modo, o estudo relevou que a maior distribuição percentual e maior incidência está em mulheres com idade acima de 30 anos e proveniente da comunidade quilombola, sendo assim as mulheres maiores detentoras sobre o conhecimento das plantas medicinais. Destaca – se também que os conhecimentos são adquiridos por pais/avós, ou sejam, passam de geração para geração. E dentre as diversas plantas citadas, o boldo foi o que mais foi referido (13,78%) indicado para tratamento de doenças relacionas ao fígado, seguido do mastruz (6,89%) indicado para questões inflamatórias e dentre outras plantas citadas. Portanto, os resultados do estudo possibilitaram perceber a importância da fitoterapia no
tratamento de doenças crônicas não transmissíveis, como a fitoterapia pode atuar de forma
alternativa e positiva na terapia e prevenção de várias patologias como o câncer e a obesidade.

Segundo o Centro para o Avanço da Educação Interprofissional (CAIPE), define-se como educação interprofissional (EIP) “ocasiões em que que duas ou mais profissões aprendem com uma com a outra e sobre a outra para melhorar a colaboração e a qualidade do atendimento”. A Universidade Federal do Amapá (Unifap) desenvolveu o PET Interprofissional em Saúde, proporcionando a interação entre estudantes dos cursos de Biologia, Enfermagem, Farmácia, Fisioterapia e Medicina. O presente estudo questiona qual a diferença de percepção da experiência vivenciada pelos discentes do programa sobre a formação interprofissional em saúde e práticas colaborativas, e discentes que não tiveram contato com tais práticas. Acredita-se que a experiência contribuiu com a formação de conhecimentos teórico-práticos e habilidades interprofissionais. Com objetivo investigar como a EIP foi percebida por estudantes que participaram do programa PET Saúde interprofissional na Unifap e estudantes de cursos de saúde em geral do estado do Amapá, foi realizado um estudo quantitativo comparativo, com abordagem transversal, através de instrumento sociodemográfico e da Escala de Prontidão para Aprendizagem Interprofissional. Como resultado à escala, o grupo que participou do PET fez um escore geral médio de 115 pontos, enquanto o grupo que não participou obteve 113. Apesar da proximidade, ao passar por avaliação estatística, essa diferença é significante, comprovando maior disponibilidade do grupo PET à EIP, inclusive quando comparado em subcategorias “Trabalho em equipe e colaboração”, “Identidade profissional” e “Atenção à saúde centrada no paciente”, tendo especial significância estatística no 1o e 3o fatores. É notória a contribuição do grupo de extensão, portando sugere-se a continuidade de pesquisas locais sobre EIP e experimentação de novos métodos, como implantação de disciplinas interprofissionais.

Introdução: a gestação consiste em um momento que possui riscos intrínsecos à saúde do binômio materno-fetal, somado a isso, a pandemia da COVID-19 trouxe diversos potenciais riscos e agravos à saúde desse público. Diante disso, houve a necessidade de adequação dos profissionais de saúde na intensificação do pré-natal enquanto ferramenta de rastreio e prevenção de agravos durante todo o período gravídico-puerperal no contexto de pandemia. Objetivo: Analisar as experiências de profissionais da Atenção Primária à Saúde do Estado do Amapá para assegurar o seguimento do pré-natal durante a pandemia da COVID-19. Material e métodos: Pesquisa qualitativa, narrativa, com coleta de dados realizada por meio de entrevista semiestruturada com profissionais enfermeiros, médicos, nutricionistas e cirurgiões-dentistas da Atenção Primária à Saúde (APS) dos municípios de Macapá e Santana. Para o número de participantes da pesquisa utilizou-se os métodos de: cálculo amostral para um apontamento inicial do possível número de participantes, e saturação para o número real de profissionais incluídos. As entrevistas foram gravadas, transcritas e os conteúdos textuais processados no software IRAMUTEQ e analisados através da Classificação Hierárquica Descendente, Análise de Similitude, Nuvem de Palavras; e Análise Temática proposta por Braun e Clarke (2006). Resultados: Foram entrevistados 55 profissionais enfermeiros, médicos, nutricionistas e dentistas de 23 Unidades Básicas de Saúde dos municípios de Macapá e Santana. No corpus textual composto pelas narrativas submetido à análise no software foram observadas 93.955 ocorrências de palavras, sendo 5.726 formas distintas. O software dividiu o corpus textual em 3.240 segmentos de texto, dos quais, agrupou 90,25% por meio da Classificação Hierárquica Descendente que associada à Análise Temática resultou nos temas: 1) A pandemia e os novos olhares ao pré- natal e 2) O pré-natal na pandemia: fragilidades e potencialidades, que abordam as novas adaptações realizadas pelos serviços de saúde bem como pelos profissionais para garantir o seguimento do pré-natal no contexto pandêmico, além das fragilidades e potencialidades contidas nas experiências dos profissionais de saúde das APS dos municípios de Macapá e Santana. Considerações Finais: Os achados evidenciam por meio da análise das experiências dos participantes, a compreensão das singularidades das ações conjuntas entre profissionais de saúde, instâncias sanitárias e governamentais municipais, e serviços de saúde para assegurar o pré-natal de qualidade na pandemia da Covid-19. Além disso, as principais fragilidades evidenciadas relacionam-se ao pré-natal e às suas experiências, em função da acentuação das fragilidades de acesso ao pré-natal e desigualdades sociais, e implicações psicossociais causadas nos profissionais de saúde. As potencialidades refletem especialmente a capacidade de resiliência dos profissionais frente às adversidades do contexto pandêmico, ressaltando aspectos como: oportunidade de aquisição de conhecimentos, maior senso de empatia, compaixão, e humanização da assistência, sobretudo ao pré-natal.

Introdução: A COVID-19, doença causada pelo vírus SARS-CoV-2 foi declarada em março de 2020 pela Organização Mundial da Saúde como pandemia, concretizando-se em um grave problema de saúde pública pela rápida disseminação e difícil contenção, com milhares de casos e mortos ao redor do mundo. Considerando esse contexto, das produções cientificas relacionadas ao tema sobre COVI-19 em crianças e o impacto de processos patológicos causados por infecção viral na população infantil, torna-se relevante identificar aspectos ligados à COVID-19 em pediatria. Desta forma, esta pesquisa objetiva analisar as características clínicas e epidemiológicas de crianças internadas por COVID-19 em um estado da Amazônia Brasileira. Quanto aos objetivos específicos, visa identificar e descrever as variáveis sociodemográficas na população em estudo; caracterizar a população investigada segundo as variáveis clínicas e epidemiológicas; calcular as taxas de incidência, prevalência e letalidade de crianças internadas por COVID-19 e relacionar as variáveis sociodemográfica, às variáveis clínicas e epidemiológicas da população em estudo. Material e métodos: estudo
observacional, descritivo, retrospectivo e documental com abordagem quantitativa de casos de internação pediátrica por COVID-19, compreendendo o período de fevereiro de 2020 a fevereiro de 2022. Foi utilizado para a coleta de dados um questionário sociodemográfico, epidemiológico e clínico no HCA e extraído dados de um banco nacional que inclui todos os casos de internação por Síndrome Respiratória Aguda Grave no Estado do Amapá. Resultado e Discussão: No estado do Amapá de fevereiro de 2020 a fevereiro de 2022 foram internadas
982 crianças (0 a 12 anos), destas 489 (49,8%) confirmadas para SRAG/COVID-19. São do sexo masculino (67,6%), sendo a faixa etária mais atingida lactentes (39%), com maior concentração de casos no primeiro ano de vida (33,8%) e raça mais atingida a negra/parda (86%). Os resultados das associações de qui-quadrado entre desfecho e variáveis de sintomas demonstrou ser significativa para dispneia (p = 0.000) e desconforto respiratório (p = 0.002) e saturação (p 0.001). Os dados clínicos de desfechos, onde 11,6% das crianças frequentaram leitos de UTI, 5,1 % fizeram uso de suporte ventilatório invasivo e 14,3% fizeram uso de suporte ventilatório não invasivo. Dessas crianças, 96.67% evoluíram para cura e 3,33% evoluíram ao óbito. Os dados apontam que os casos de COVID-19 em crianças na maioria das vezes apresentam sintomas leves e moderados, porém também pode se manifestar como uma doença grave em crianças, necessitando de UTI e ventilação mecânica e, entre os fatores de risco idade menor de dois anos de vida pode estar relacionada a maior internação pela doença. Foram observadas taxas de letalidade geral para os anos de 2020, 2021 e 2022 com os seguintes valores respectivos 1.93%, 2.87% e 12.24% configurando um cenário de aumento na taxa a partir de sua origem. Os sintomas mais relatados nas fichas dos pacientes internados por SRAG/COVID-19 foram febre (86,7%), tosse (78,5%), desconforto respiratório (37,7%), diarreia (34,5%) e vômito (30,6%). Os fatores de risco mais comuns presentes no banco de dados da SRAG/COVID-19, de acordo com os prontuários, foram asma (38.3%), doença neurológica (17.7%) e cardiopatias (17.5%). Considerações finais: Estudos epidemiológicos como este são determinantes para fornecer dados que podem ajudar a estruturar políticas públicas e práticas clínicas de saúde, visando a prevenção, tratamento e controle da infecção promovendo a saúde da criança frente à infecção por SARS-CoV-2 em unidades pediátricas, além de corroborar com pesquisas futuras sobre a temática, em especial na região Norte do Brasil.

Introdução: Os fisioterapeutas possuem um papel central no tratamento conservador da osteoartrite (OA) de joelho. Atualmente existem diversas diretrizes clínicas que podem nortear estes profissionais na escolha das melhores estratégias de tratamento para abordar pacientes com OA de joelho, no entanto ainda há incertezas sobre as preferências terapêuticas de fisioterapeutas brasileiros para tratar pacientes com OA de joelho e se suas escolhas estão de acordo com as recomendações atuais. Objetivo: Conhecer quais condutas terapêuticas estão sendo utilizadas por fisioterapeutas brasileiros para tratar osteoartrite de joelho e se estas estão de acordo com as recomendações atuais. Metodologia: trata-se de um estudo transversal do tipo Survey, com fisioterapeutas brasileiros. A coleta de dados foi gerenciada através do aplicativo Google Forms, o qual forneceu um link de acesso direto ao formulário de pesquisa disponibilizado aos fisioterapeutas por meio das redes sociais e através dos Conselhos Regionais de Fisioterapia e Terapia Ocupacional (CREFITO) via e-mail e das suas respectivas redes sociais. As informações coletadas incluíram dados pessoais dos participantes, perfil profissional e condutas profissionais. Os dados foram analisados estatisticamente por meio do software SPSS (Statistical Package for the Social Sciences), versão 25.0. Frequências absolutas e percentuais foram geradas para as variáveis categóricas e média e desvio-padrão para as numéricas. Foi utilizado o teste qui-quadrado para investigar a associação entre as variáveis dependentes (uso das bases de dados, utilização de diretrizes clínicas, tipo de recomendações utilizadas) e as variáveis independentes (qualificação profissional e regiões brasileiras). Foi realizado a análise regressão logística multinomial para investigar a relação entre o tempo de formação dos participantes e qualificação profissional com uso de diretrizes clínicas. Foi estabelecido nível de significância p<0,05. Resultados: 303 participantes responderam à pesquisa, destes a maioria eram do sexo feminino, com média de idade de 35,92 ± 9,83 anos. 52,8% dos participantes eram da Região Sudeste do Brasil, 37,0% tinham menos de 5 anos de experiência profissional e 58,1% possuíam especialização/residência como maior qualificação profissional e 75,6% disseram que consultam diretrizes clínicas. 90,1% dos fisioterapeutas relatam utilizar exercício terapêutico como tratamento, 79,9% fazem orientações sobre a doença e seu controle e 72,6% mobilização articular. A Web of Science foi a base de dados mais utilizada por especialistas/residentes da região Sudeste, a LILACs foi mais relatada por bacharéis da região Sul e especialistas/residentes da região Sudeste. Fisioterapeutas bacharéis da região Sudeste foram os que mais relataram que não consultam bases de dados. Profissionais com mestrado/doutorado demonstraram utilizar com maior frequência recomendações classificadas como a favor, forte/condicional pelas diretrizes. A maior parte dos fisioterapeutas que residem nas regiões Norte, Nordeste, Centro-oeste e Sudeste do Brasil, que possuem especialização/residência, apontaram utilizar com maior frequência recomendação classificada como forte/condicionalmente indicadas pelas diretrizes. Não houve relação em utilizar diretrizes clínicas e a qualificação profissional e tempo de formado dos participantes. Conclusão: A maioria dos participantes deste estudo demonstraram utilizar condutas recomendadas pelas diretrizes atuais para tratar seus pacientes com AO de joelho.

Os artrópodes hematófagos têm se tornado um problema de saúde pública de grande relevância nos países tropicais e sub-tropicais. Os mosquitos, são endêmicos nestas áreas e transmitem muitas doenças, em especial o Aedes aegypti. O uso dos inseticidas químicos sintéticos em grande escala e a pequeno grupo de inseticidas sintéticos liberados pela Organização Mundial de Saúde-OMS tem gerado problemas como a resistência do A. aegypti. O repelente tópico é uma barreira para a picada do mosquito e em muitos casos, este é a única forma de proteção. O objetivo deste trabalho foi avaliar a atividade repelente de formulações tópicas a partir do óleo essencial de Protium heptaphyllum diante do mosquito A. aegypti. A metodologia utilizada para extrair o óleo essencial da resina foi de arraste a vapor. A análise fitoquímica observada do cromatrograma e espectrometro de massa do óleo detectou como componente majoritário o para-cimeno 60,59%  . O óleo foi incorporado a bases tópicas para realização do bioensaio em voluntários humanos. O desenvolvimento do bioensaio foi em gaiola 40x40x40cm contendo 50 mosquitos fêmeas conforme o protocolo padrão de avaliação de repelentes em humanos, recomendado pela Organização Mundial da Saúde. Formulações em concentrações variadas foram testadas, o controle negativo foi a base formulada e o controle positivo foi o repelente comercial DEET a 12,5%. Os resultados obtidos mostraram atividade repelente nas formulações tópicas, creme e loção, porém os melhores resultados foram obtidos com a loção hidroalcoólica com uma média de índice de proteção acima de 60% em até 120 minutos. 

Os atributos do ambiente construído podem interferir nos níveis de atividade física das pessoas. Essa relação têm sido investigada em muitos estudos internacionais e alguns nacionais que testaram e comprovaram que há associação de determinados aspectos do ambiente com os níveis de atividade física da população. Este é o primeiro estudo da região norte do Brasil a testar essa associação. Objetivo: Correlacionar os atributos do ambiente construído aos níveis de atividade física em adultos. Método: Trata-se de um estudo de natureza quantitativa e do tipo transveral realizado entre os meses de setembro de 2021 a fevereiro de 2022 em um bairro da cidade de Macapá/AP. A coleta de dados se deu por meio de visitas domiciliares cumprindo todos os protocolos de segurança estabelecidos pelo Ministério da Saúde (MS) (2021) para a pandemia de COVID-19, como o uso de máscaras, distanciamento de 1,5 metros entre o pesquisador e o participante, e uso de álcool em gel. Foi adotado como critério de inclusão para a participação na pesquisa, os sujeitos que provaram a maioridade por meio de documento oficial com foto, que fossem moradores do bairro e ruas selecionadas e que estivessem aparentemente saudáveis, sem limitações físicas ou cognitivas que os impossibilitassem de praticar atividade física. Para obtenção de dados sobre a percepção do ambiente construído, ultizou-se o instrumento NEWS-A (versão curta) e para a coleta dos níveis de atividade fisica foi utilizado o instrumento IPAQ (versão curta). Os dados foram organizados utilizando o Microsoftware Excel 2016. Foi utilizado um nível de significância de 5% (p≤0,05). A composição dos resultados foi dada pelo software estatístico SPSS.26® na realização da análise descritiva (frequência, média e desvio padrão). Resultados: O estudo obteve a participação de 216 voluntários de ambos os sexos, com prevalência do sexo feminino. Quanto a classificação dos níveis de atividade
física, os participantes foram agrupados em dois grupos distintos: suficientemente ativo e insuficientemente ativo e o estudo revelou que a maioria dos participantes estão classificados como “insuficientemente ativos”. Dentre os oito domínios relacionados à percepção do ambiente que fazem parte do NEWS-A, foram encontradas diferenças significativas nos domínios proximidade de lojas, acesso a serviços, estética de bairro e crime. Conclusão: Este estudo evidenciou que a maioria dos participantes apresentaram percepções negativas acerca dos domínios: conectividade de ruas, lugares para caminhar/andar de bicicleta, estética de bairro, segurança no trânsito e crime. Entretando, possuem percepções mais favoráveis em relação a proximidade de lojas e de acesso a serviços. Destaca-se ainda que os atributos do ambiente construído podem interferir nos níveis de atividade física da população. Encontraram-se evidências nesta pesquisa de que a percepção positiva sobre proximidade de lojas, acesso a serviços e estética de bairro tem
relação com o aumento dos níveis de atividade física dos moradores do bairro Congós.
Enquanto que a percepção negativa sobre a segurança do bairro, demonstrou relação com
a diminuição nos níveis de atividade física dos participantes do estudo.

Introduction: Brazil is recognized as one of the world record holders for traffic accidents. The problem is revealed not only by the absolute number of accidents, but also by the high incidence of accidents per person or vehicle in circulation and has caused concern for the health, safety and traffic sector. Injuries and deaths from traffic accidents have a great impact on the health of the population, great pain for families, contribute to the decrease in quality and life expectancy of young people, as well as bringing high social costs with health care, welfare and absenteeism from work. In this sense, due to traffic accident deaths, especially in young adults, the analysis and dissemination of information constitutes a product of collective interest under the intersectoral perspective of health promotion, allowing to direct government policies and actions as well as control Social. Objective: To describe the socio-epidemiological characteristics of victims of accidents with deaths and how the distribution of fatal traffic accidents occurs in the metropolitan region of Macapá from 2013 to 2017. Methodology: This is a descriptive epidemiological study of a quantitative, retrospective and documentary from the analysis of data recorded in the Mortality Information System (SIM). Due to the lack of comprehensive and representative information on the locations, times, date and type of victim of fatal traffic accidents, data from the Transit Observatory of Amapá will also be analyzed. The data will be tabulated in TABWIN32 3.0 and in EXCEL 2010, statistical tests will be performed in the SPSS 26.0 Software (Statistical Package for the Social Sciencies). Expected results: It is expected to describe the socio-epidemiological characteristics of fatal victims and the distribution of accidents in order to allow proposing interventions for the prevention and reduction of injuries and deaths caused by traffic, implementing intersectoral, integrated strategies involving Health, Traffic, Education and all organized civil society.

O avanço das arboviroses representa um enorme desafio à infraestrutura do sistema público de
saúde brasileiro. Os arbovírus são transmitidos na natureza por meio de artrópodes hematófagos ou
hospedeiro artrópode e se multiplicam produzindo viremia nos vertebrados suscetíveis após incubação
extrínseca. A diversidade de arbovírus na região amazônica é altamente influenciada pela antropização
de ambientes outrora preservados, com destaque ao desmatamento e à ocupação de áreas naturais para
a construção de assentamentos rurais e desempenho de atividades econômicas como agricultura,
pecuária e extrativismo. O objetivo geral da pesquisa foi caracterizar a diversidade dentre os arbovírus
circulantes em mosquitos Aedes aegypti, Aedes albopictus e Anopheles spp. nos municípios de Macapá,
Santana e Mazagão, Amapá, Amazônia Oriental, utilizando a tecnologia de sequenciamento em larga
escala (Next Generation Sequencing, NGS) para a identificação dos mesmos. Foram realizadas coletas
de espécimes adultos de Aedes aegypti, Aedes albopictus e Anopheles spp., utilizando as técnicas de
busca ativa com atrativo humano protegido, com auxílio de capturador manual de Castro e rede
entomológica pequena. As coletas foram realizadas entre agosto de 2019 e fevereiro de 2020, nos
períodos mais e menos chuvosos. Após isto, foi realizada a identificação e formação de pools de
mosquitos que foram conservados em reagente RNA-later e armazenados em freezer a – 80o C, sendo
posteriormente transportados para o Laboratório de Retrovirologia da Universidade Federal de São
Paulo (UNIFESP). Assim, os pools foram processados para serem sequenciados pelo NGS. Em março
de 2020, durante um treinamento teórico-prático no Laboratório de Retrovirologia da UNIFESP, foram
realizados os procedimentos metagenômica viral e NGS dos arbovírus contidos nas amostras de
mosquitos, que englobaram as seguintes etapas: maceração dos pools de mosquitos, purificação dos
ácidos nucleicos, sequenciamento e análises dos dados por ferramentas de bioinformática. Os dados
gerados no NGS foram enviados para Universidade da Califórnia (UCSF, Vitalant Institute), onde foram
analisados por um pipeline (algoritmo de ferramentas de bioinformática). Os resultados foram expressos
em números de hits (melhores alinhamentos obtidos no BLASTn e BLASTx) ou por sua relevância
epidemiológica. Um total de 525 espécimes de mosquitos foram obtidos, classificados taxonomicamente
nos gêneros Aedes (330 espécimes, correspondendo a 62.86 % do total da coleta) e Anopheles (195
espécimes, correspondendo a 37.14 % do total da coleta), com 08 espécies coletadas nos municípios de
Macapá, Santana e Mazagão: Aedes aegypti; Aedes albopictus; Anopheles darlingi; Anopheles
albitarsis; Anopheles braziliensis; Anopheles nuneztovari; Anopheles triannulatus e Anopheles
peryassui. Os vírus identificados foram categorizados entre: vírus específicos de mosquitos (sem
potencial patogênico para humanos ou vertebrados), vírus com potencial patogênico para humanos e
vertebrados e vírus unclassified (não-classificados). Dentre os vírus identificados com maior detecção

nos pools se destacaram os vírus Chikungunya (1130 hits), vírus Renna (517 hits), Wenzhou sobemo-
like virus 4 (61 hits) e Onyong-nyong virus (61 hits).

No Brasil, o câncer de mama é a neoplasia mais frequente entre as mulheres em todas as Regiões brasileiras, com taxa ajustada de 43,7%, e a primeira causa de morte por câncer na população feminina em todas as regiões brasileiras, com exceção da Região Norte. A mortalidade por câncer de mama no país ainda se mostra crescente, o que pode ser atribuído ao retardo no diagnóstico e atraso na instituição de tratamento adequado. Estudos descritivos, como este, são fundamentais para produzir informações que embasarão o planejamento de ações, o direcionamento de tomadas de decisões e o desenvolvimento de políticas voltadas à atenção oncológica, com o objetivo de facilitar o acesso aos serviços de saúde e diminuir o tempo de espera para o diagnóstico. Sendo assim, o objetivo do presente estudo foi verificar se ocorreu atraso, de acordo com o prazo de 60 dias recomendado pelo INCA para o estabelecimento do diagnóstico. Secundariamente, objetivou-se mensurar o tempo de espera para o diagnóstico do câncer de mama, descrever as variáveis sociodemográficas e clínicas, bem como os eventos relacionados à obtenção do diagnóstico. O estudo observacional transversal contou com a participação de 68 participantes, recrutadas na cidade de Macapá/AP, através de chamadas públicas em mídias sociais e aplicativo de mensagens instantâneas, bem como chamadas diretas a participantes do Projeto Criando Laços-UNIFAP e do Grupo POUVA – Pacientes Oncológicos Unidos pela Vida e pelo Amor. Os dados foram coletados no período de novembro de 2020 a julho de 2021 através de questionário semiestruturado. Após as análises descritivas, concluiu-se que 43 (63%) participantes foram diagnosticadas com atraso, com média de 385,21 (64,00-1649,00) dias; enquanto 25 (37%) mulheres foram diagnosticadas dentro do prazo recomendado de 60 dias, com média de 33,40 (3,00-60,00) dias, apresentando diferença significativa entre as médias (p<0,001).

Neoplasms are the most frequent and aggressive diseases in the prostate, they can be of the benign and malignant type, such as benign prostatic hyperplasia (BPH) and prostate cancer respectively (CaP). These pathologies have a multifactorial etiology, highlighting genetic factors as essential in this process. The objective of this work was to evaluate the gene expression profile of the HHLA2, CREB3L4, TRIP13 and HOXC6 targets in cells with HPB and Cap. For this purpose, RNA sequences isolated from patients undergoing prostate tissue biopsy and who signed the consent to participate in the study. The study involves RNA extraction, complementary DNA synthesis and the relative quantification of gene expression by real-time PCR. This research intends to demonstrate the level of association of these genes in the development of neoplasms, since the chosen targets have been gaining great prominence in pharmacogenetics and data were not obtained in the Amapá population.

Cystic fibrosis is a rare chronic, progressive and disabling disease that affects the quality of life not only of affected people but also of their families. Family resilience within the context of cystic fibrosis is evidenced as an intrinsic and interrelated process with quality of life, requiring a sensitive and broader look at the object of study. Objectives: Analyze the quality of life of families of children with cystic fibrosis and understand how family resilience is expressed. Method: This is a descriptive cross-sectional study with a quantitative-qualitative approach. The Whoqol Bref Questionnaire was used. The entire universe of children diagnosed with cystic fibrosis in the state of Amapá until May 2021 was used, with eight children and seven families. For the analysis of quantitative data, descriptive statistical analysis was performed. Inferential analysis was used to assess the most representative dimensions of the Whoqol Bref that influence the quality of life of families of children with Cystic Fibrosis. The level of statistical significance adopted is p < 0.05. For tabulation and analysis of quantitative data, the SPSS software version 26 was used. To understand how family resilience is expressed, a qualitative approach was chosen as an interpretive methodology. Its theoretical framework was symbolic interactionism and narrative research as its methodological framework. Thematic analysis of the narratives guided the technique of treating qualitative data. Results: It was identified that all families had an overall quality of life score classified as regular (100%). As for the domain scores, it revealed that the social and environmental relationships domain reached the lowest relative frequencies of quality of life. Regarding the understanding of family resilience in the context of families of children with cystic fibrosis, six themes were identified: the family facing the first manifestations of the disease; the family facing the diagnosis; the family experiencing non-assertive diagnoses, treatment from the perspective of the family; the magnitude of the treatment on the quality of life of the child and family; resilience in the trajectory of families. Final considerations: This study showed cystic fibrosis within the context of a rare disease as a pathology with a long diagnostic and therapeutic trajectory, marked by adversities that contribute to a low quality of life, in addition to imposing challenges and coping needs on families.

Repetitive strain injury (RSI) and work-related musculoskeletal disorders (WMSD) are considered a public health problem because of their high prevalence in several professions, including dental professionals. Because of bad posture and organization at work, for example, dental surgeons occupy the first place in leaves of absence from work due to temporary or permanent incapacity, accounting for approximately 30% of the causes of premature abandonment among medical activities. This reality, however, continues to be underestimated and the lack of concern with prevention is one of the biggest challenges for the identification and change of this situation. Thus, the objective of this study was to evaluate the prevalence of musculoskeletal symptoms and their relationship with sociodemographic aspects and laboratory test results among dental surgeons in the Macapá and Santana cities. Those who met the inclusion criteria and agreed to participate in the research upon authorization, were given two self-administered questionnaires, the instrument used to collect sociodemographic and occupational data, and the instrument validated for the measurement of morbidities "Nordic Questionnaire of Musculoskeletal Symptoms", in addition to to collect your blood samples for hematological and biochemical tests. The research was carried out with dentists from public or private networks, with the exception of those who were on vacation, or for any reason, away from their activities in the last 15 days. The average working time of professionals is 12.2 years, with an average workweek of 38.2 hours, and 32.5% have already been away from work due to musculoskeletal problems. The prevalences of musculoskeletal symptoms and work-related musculoskeletal symptoms are 92.5% and 87.5%. And on average, dentists had 5 symptomatic regions of which 2.9 were work-related.

The order Diptera receives great focus from the scientific community due to its importance as a vector, active or passive, of pathogenic organisms that cause diseases to man, the so-called arboviruses. Hematophagous vectors, the group to which mosquitoes are inserted, can transmit a wide range of infectious diseases during their feeding process. Major outbreaks of dengue, malaria, chikungunya, yellow fever and Zika have been reported, claiming human lives in several countries. The control of these insects is essential to decrease the transmission of such arboviruses and the ideal form of control of these insects needs to be carried out in such a way that the aggression to the environment is minimized, reaching only the target organisms, avoiding the selection of resistant insects, causing the minimum environmental contamination, substantially reducing the number of cases of infections and possible deaths resulting from the transmission of different pathogens transmissible by these vectors, with natural plant extracts being a valuable option. The species Annona glabra is a member of the family Annonaceae popularly known as araticum, marsh araticum, alligator apple or pond-apple. A small plant found in tropical and subtropical regions, which can live in association with other plants and commonly inhabit the banks of lakes and rivers, developing in environments subject to floods such as mangroves. The scientific literature presents reports of its anticarcinogenic, antitumor, antimutagenic, antileukemic, antioxidant, emollient, reverse transcriptase (HIV-1), antimicrobial, antiparasitic, antimalarial and antifungal properties. Phytochemical studies derived from extractions from different parts of the plant revealed the presence of flavonoids, terpenoids, glycosides, steroids, saponins,tannins, anthraquinones and acid compounds. Thus, the present study aimed to verify the viability of using the fixed oil of A. glabra to control the species Aedes aegypti in the larval (L4 - immature) and pupal phases; and check the LD50 and LD90.
Keywords: Annona glabra. Aedes aegypti. Biological control. Insecticide.

Introduction- The social determinants (DSS) of health according to the World Health Organization (WHO) are 

related to the conditions in which a person lives and works. Social, economic, cultural, ethnic / racial, 

psychological and behavioral factors that influence the occurrence of health problems and risk factors to 

the population, such as housing, food, education, income and employment, can also be considered.

 In the case of farmers, several DSS are added to accentuate the health-disease process, especially the 

working conditions and environments that are often involved in the use of pesticides. 

Objectives- For this reason this study set out to discuss how the environment and working conditions 

and other health determinants are risks of occupational illness in family farming workers who work at 

the buritizal fair. Methods- For this, an observational epidemiological study of the descriptive and 

transversal type was carried out with a quantitative and qualitative approach, with the application of 

a form to workers at the buritizal fair with questions to verify the social determinants of health of

 this group and the perception of symptoms related to poisoning pesticides in the last 6 months. 

In addition, a visit was made to the farmers' production area in order to check for distortions in work 

safety, verifying health risks to which this worker is exposed. Results Family farmers in the vegetable 

industry who work at the buritizal fair are the majority (87.6%) of the Km 9 region, the farm's mini and pole.

 The 43.8% level of education is for people who have studied less than 4 years. With a prevalent age group of 

46.7% of people between 37 and 55 years old, 40% over 55 years old. 93.4% say they work more than 8 hours

 a day. Regarding the daily family income per capita, 33.3% live with an income of 20 reais or more and 26.7%

 with an income between 10 and 14 reais per capita per day. 66.7% say they do not use pesticides and 33.7% 

say they do. 73.3% think that the use of these products can be harmful to health. 53.3% say they do not have 

any leisure activity and 73.4% say they have never taken a month off. Regarding the frequency of consultations,

 80% say they spend more than 36 months without consulting with any health professional and 53.3% say they 

feel musculoskeletal pain, besides 80% say they do not use sunscreen and 53.3% evaluate their health offered by

 the State and municipality where they reside as very bad. It is important to note that the region where the

 farmers live does not have a supply of treated water, sewage and garbage collection is present in only 50% of 

the interviewees' homes. During visits to the production area of part of the sample, there was a contradiction 

between the statement of not using pesticides with the presence of product packaging in the production area. 

In addition, the personal protective equipment demonstrated was practically non-existent, exposing the worker

 to risks arising from the incorrect use of pesticides. Conclusion- Preliminary results demonstrate that the

 studied DSS are risk factors for increasing the health-disease process of the people surveyed and the use of 

pesticides is still a reality in the production of many family farmers, and further research is necessary to

 verify the conditions exposure to these products and other risks arising from work.

Keywords: Social determinants of health. Pesticides. Desktop. Family farming.

As doenças infecciosas e parasitárias (DIP) são um grave problema de saúde Pública devido suas particularidades vinculadas às variantes demográficas e socioeconômicas de cada região, que expressam a condição de saúde. Resultante da transição epidemiológica e suas consequências, as DIP passaram a não ser a
principal causa de morte, porém ainda se enquadram em situação de saúde preocupante e objetivo de campanhas de prevenção e tratamento. Assim, a investigação epidemiológica dos dados de mortalidade por DIP refletem a situação de saúde da população, dos serviços de saúde e pode direcionar à ações e políticas públicas locais voltadas ao tema. Esta pesquisa trata-se de um estudo transversal retrospectivo, com abordagem quantitativa que teve por objetivo realizar a caracterização epidemiologia dos óbitos por DIP no Estado do Amapá, nos anos de 2007 à 2017 através das análises dos dados de óbitos contidos no banco de dados do DATASUS, provenientes do sistema de informação de mortalidade - SIM. Os dados coletados foram referentes ao período de janeiro de 2007 a dezembro de 2017. Foram incluídos todos os óbitos do capítulo I do CID 10. Foram descritas as DIP com maior taxa de mortalidade no período de estudo e realizado a evolução da mortalidade por
DIP no Estado do Amapá. Foram registrados 28.034 óbitos por causa gerais no Amapá de 2007 a 2017, dentre esses, 1.481 óbitos por doenças infecciosas e parasitárias com média de taxa de mortalidade de 20,12 por 100.000 habitantes. As DIP com maiores percentuais proporcionais foram: septicemia (37,2%), HIV (22,4%), diarreia (8,91%) e tuberculose (7,90%). Verificou-se de um aumento médio significativo de 6,47 óbitos por ano (R = 6,47; β = 0,92; p < 0,001). O número de óbitos egistados em 2017 foi 70,2% superior ao registado no ano inicial, em 200, maiores taxas de mortalidade em menores de 5 anos e aumento na idade média dos óbitos.
Levando à reflexão sobre maior investigação acerca das principais DIP causadoras de óbitos bem como controle dessas doenças, fortalecimento da vigilância epidemiológica e avanço no diagnóstico precoce e tratamento oportuno dessas morbidades.

O objetivo deste estudo foi estratificar o risco para doenças cardiovasculares em policiais militares do estado do Amapá. O estudo foi realizado no 1o Batalhão da Policia Militar do estado do Amapá com 101 policiais militares durante o processo de inspeção em saúde nos policiais que estavam aptos para a progressão de cargo. Para alcançar os resultados, a coleta de dados foi feita através de avaliação de exames laboratoriais (colesterol total, HDL, LDL e triglicerídeos), na Policlínica da sede do 1o Batalhão da Polícia Militar. A avaliação de saúde foi necessária para a verificação da pressão arterial e circunferência abdominal. Foi enviado um questionário online para cada participante, relativo à pesquisa sociodemográfica e econômica (ABEP), nível de atividade física (IPAQ) versão curta e Escala sueca de demanda-apoio. Os dados coletados foram analisados pelo SPSS, versão 26. As variáveis qualitativas foram caraterizadas através de frequências absolutas e relativas. Para as variáveis quantitativas foram utilizadas as medidas descritivas mínimo, máximo, média e desvio padrão. Os resultados foram avaliados pelo Coeficiente de Correlação de Spearman e teste exato de Fisher. A escala de estresse foi
confiável após aplicação do coeficiente de consistência interna Alpha de Cronbach. A maioria da amostra foi composta por homens (89,1%), com uma média de idade de 41,2 anos. Foi observado uma relação positiva entre aumento do risco cardiovascular com aumento da idade, na faixa etária de 50-56 anos, com 54,5% com risco intermediário e 45,5% com risco alto. Trabalhadores com ensino médio tiveram 28,6% com risco alto/muito alto, comparado com 9,2% dos policiais com Ensino Superior. Maior tempo de trabalho teve forte relação com o risco alto (p<0,001). Trabalhadores em setores administrativos teve forte relação com o alto
risco (25,6% versus 3,2% em trabalho operacional). O risco cardiovascular alto esteve mais presente em trabalhadores com dislipidemias (p=0,014) e hipertensos (p<0,001). 48,4% tinham excesso de peso e 27,4% com obesidade, estando presente a relação positiva entre estado nutricional com maior risco (p=0,042). Foram encontradas correlações positivas significativas do colesterol total (R = 0.251, p = 0.011), do LDL (R = 0.270, p = 0.006) e dos triglicerídeos (R = 0.288, p = 0.003) com o risco cardiovascular, indicando que o aumento dos valores de colesterol total, de LDL e de triglicerídeos leva a um aumento do risco cardiovascular. O aumento da C.A está positivamente correlacionada com o risco cardiovascular (R = 0.342, p = 0.010). 24,2% dos policiais foram classificados com comportamento sedentário. Não houve relação com o estresse e risco cardiovascular. Espera-se que a prevenção primária da aterosclerose ocorra de forma pontual nesta população do estudo e que não sejam apenas avaliados na ocasião de promoção de cargo ou quando houver sintomatologia importante.

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Violence against children and adolescents is currently configured as a public health problem, considering the various traumas caused in different dimensions of the human being, whether physical, psychological or social, that require different forms of care at all levels of health, such as in the creation of new public policies that allow the identification of risk factors that caused this problem, among them, the creation of new strategies that allow from the complaint to the recovery of the victims' mental health. The purpose of this work is to analyze the epidemiological profile of violence against children and adolescents treated at a public hospital in Macapá between 2015 and 2019. This is a research with a quantitative, descriptive, retrospective and documentary approach, carried out at a public hospital in Macapá. The sample comprises 122 participants between zero and 12 years of age. Among the main results, children and adolescents who have suffered some type of violence are mostly female, aged between zero and 12 years old, are children of separated parents, belong to the lower class, lived in urban areas, and how much the type of violence predominated sexual violence and some were the result of a sexually transmitted infection. it can be deduced that violence causes negative results for its victims, hence the great importance of describing the characteristics of this population so that prevention and follow-up can be found. Keywords: violence; children; adolescents.

Understanding the influence of the visual response to color contrasts and luminance is indispensable for a better understanding of visual processing under natural conditions. Current studies point out that with aging, humans present modifications in color perception and have decreased sensitivity especially after 40 years of age. Thus, we proposed in this research, to compare the influence of age on threshold perception of luminance masked by color noise in subjects distributed into two age groups, from 20 to 40 years old and over 50 years old, without comorbidities. This was an observational study of the cross-sectional analytic-descriptive type, conducted in the Neurology Laboratory of the Universidade Federal do Amapá - UNIFAP, where 42 volunteers participated, half for each age group, who were recruited through an invitation published in social networks. The participants were submitted to a previous interview to investigate the presence of neurological, metabolic and degenerative diseases that could compromise vision, then 03 psychophysical tests were performed, being 02 screening tests: the assessment of visual acuity (FrACT) and the Ishihara test and finally, the final test of this study for the evaluation of threshold luminance contrast discrimination with color masking. The risk that could arise from the research would be the extensive time spent performing the tests, which could lead to discomfort that could be relieved by taking breaks between tests and when requested by the participant. The benefits would be individual, due to the broad visual evaluation that the participant could enjoy; and collective, due to the contribution to the expansion of knowledge related to the interaction mechanisms between color and brightness in human vision, especially with advancing age. To assess data distribution, we applied the Shapiro-Wilk normality test. For analysis of variance, we used the one-way ANOVA test, followed by a Tukey's multiple comparisons test to compare parameters in each group; the unpaired Student's t-test with Welch's correction was used to compare parameters between groups. The results of the study confirm the hypothesis that advancing age affects the interaction between color and luminance, further corroborating the hypothesis that in the elderly the likely decrease in the perception of blue-yellow psychophysical mechanisms would induce decreased inhibition of color noise on threshold luminance perception.

Cervical cancer is considered a serious and persistent public health problem, a reality that could be transformed with the adhesion of women, their families and society to the Pap smear. Within this group, black women are part of a population considered vulnerable due to the high rates of morbidity and mortality in relation to socioeconomic variables and, therefore, require health policies aimed at this population. Given the above, the objective of this work is to analyze the knowledge, attitude and practice of quilombola women in Amapá on the preventive examination of cervical cancer. The study has a quantitative approach, of an applied nature, of the Inquiry type having as reference the Knowledge, Attitude and Practice of women, which intends to assist in the situational diagnosis about the theme, the study site being the quilombola community of Curiaú, located in the municipality Macapá, in the state of Amapá. The data were submitted to the SPSS version 25.0 program. for the description of the statistical results, which made it possible to state that the participants in this research have the following profile: age between 18 to 33 years (43.75%), Catholic (92.50%), is single (52.50 %), has completed high school (31.35%), has no paid activity (41.25%), has a monthly family income of 1 to 2 minimum wages (37.50%) and supports five family members (36.25%). They had a weight of 69.34 (Me), height 161.06 (Me), Body Mass Index (BMI) 26.685 (Me), waist circumference (WC) 86.97 (Me), hip circumference (CQ) 106 , 77 (Me) and ratio index between CC / QC 0.8172 (Me). Thus, the study revealed that 42.50% are within the parameter considered normal for BMI and 68.75% have low risk for the development of cardiovascular diseases according to CC / QC. Regarding the evaluation of the CAP survey, 26.25% had adequate knowledge, 30% adequate attitude and 37.5% adequate practice. Pearson's correlation test demonstrated that there is a direct relationship between the variable of knowledge and practice, thus it was identified that there is a relationship between the variability of both. Thus, highlighting that the woman has more knowledge, soon she will have a greater practice and the reverse is also true.

Descriptors: Cervical neoplasms. Pap smear test. Women's health. African Continental Ancestry Group.

Autistic Spectrum Disorder is considered a neurodevelopmental disorder characterized by qualitative and quantitative changes in communication, social interaction, isolation, lack of interest in others, and presents itself in different degrees of severity. The current context of autism and its complexity requires advances in the model of care and care provided to families, as with the onset of symptoms, they experience a series of experiences, which cause changes in the routine, affecting the psychological, finances and quality of care. life. The need to establish a support network for these families based on some strategies such as groups, health services and trained professionals, aroused the interest in carrying out this research and justifies its feasibility. The research had as a general objective: to analyze the support networks for the families of children with Autism Spectrum Disorder at a special education school in Macapá. And as specific objectives: to understand the impacts generated by the diagnosis of Autism Spectrum Disorder on the family; describe how families of children with Autism Spectrum Disorder use social support networks and the benefits guaranteed by laws; to map the institutions belonging to the support networks for children with Autistic Spectrum Disorder in Macapá, in order to demonstrate the portrait between what is advocated and the reality found. Methodologically, the research is descriptive with a quanti-qualitative approach such as multiple case studies. The study site was the Educational Center Raimundo Nonato Dias Rodrigues located in the city of Macapá. The sample comprised family members of children aged 4 to 12 years of age, with a defined diagnosis for ASD who were regularly attended at the institution during 2017 and 2018. From a population of 189 students in 2017 and 120 students in 2018, the final sample comprised 19 families (6.14%). The interviews were recorded after approval by the Research Ethics Committee under opinion No. 2,900,834 and the signing of a Free and Informed Consent Form. The results were discussed using content analysis from Bardin's perspective. The interviews were transcribed and organized according to coding and thematic categories were defined for reflective and critical analysis. It was found that the moment of diagnosis by the family is marked by shock and feelings of anguish, sadness, depression, denial and disbelief, in addition to a lack of knowledge about the pathology. In the case of support networks, the one offered by the family nucleus and by the professionals were the most evident in the speeches. It should be noted that the family is the social group that plays a determining role in the development of the child at the affective, cognitive and psychological level and must ally with professionals trained to stimulate the compromised functions in an appropriate manner. Regarding institutional support, the most sought after were: the Raimundo Nonato Dias Rodrigues Educational Center, CAPSi, CREAP and the Sara Kubistcheck chain. However, family members pointed out that only CERNDR offers long-term follow-up for children with ASD and highlighted the numerous difficulties in accessing services both through the Unified Health System and private plans.

Violence against women is a major public health problem in the world, and its maximum expression is represented by feminicide. Worldwide, in recent years, there has been a high rate in rate of feminicide, with Central America being the place of greatest occurrence. In Brazil, during the last three decades, there was an increase of 100% in the rate of feminicide, an increase from 2.3 / 100,000 to 4.6 / 100,000 women. This research aimed to characterize the epidemiological profile of feminicide cases registered in the State of Amapá from 2014 to 2018. This is an observational, descriptive, retrospective, cross-sectional study with a quantitative approach based on the database of the information service of the Superintendence of Health Surveillance of the Ministry of Health, with data on mortality and the Scientific Police of Amapá, based on death certificates. For inferential analysis, Pearson's chi-square test was performed to assess the association between cause of death by ICD-10 group and epidemiological variables, using the SPSS 26.0 program, with results with p≤0.05 being considered relevant. Although feminicide shows a decreasing trend in the State of Amapá during the study period, the final global corrected crude rate is higher than the national average, with 6.34 deaths per 100,000 women. There was an association between cause of death and age (p = 0.012), between cause of death and city of residence (p = 0.0001), between cause of death and city of occurrence (p = 0.044), between cause of death and place of occurrence of death (p = 0.027), between cause of death and the environment employed, if insidious and cruel (p = 0.001). The epidemiological profile of feminicide was that of a young woman, brown in color, with complete high school education, single, student, resident in the capital, who died in the capital itself in the hospital, without medical assistance, in October, Sunday and Wednesday, in the afternoon and by firearm.

A interação medicamentosa potencial (IMP) define a possibilidade de ocorrência da interação entre dois fármacos ou entre um fármaco e um nutriente. O risco de interação é proporcional ao número de fármacos prescritos para um paciente, e se esse paciente está hospitalizado, os riscos aumentam com a politerapia, o que torna a população idosa mais suscetível a ocorrência de IMP. O objetivo principal do presente estudo é avaliar as interações medicamentosas potenciais em prescrições de pacientes idosos hospitalizados na Clínica Médica Masculina e Feminina do Hospital de Clínicas Dr. Alberto Lima, em Macapá-AP, nos anos de 2016 a 2018. A pesquisa compreende um estudo retrospectivo, observacional de caráter descritivo, a ser realizado por meio da análise dos prontuários e prescrições de pacientes com idade igual ou superior a 60 anos internados no referido hospital, durante os anos definidos para o estudo. Através de um formulário foram coletados, de todos os pacientes que atendiam aos critérios de inclusão, dados como nome, gênero, idade, comorbidades, diagnóstico principal (descrito no resumo de alta), tempo de internação, nome dos medicamentos, vias de administração, grupo farmacológico dos medicamentos prescritos, intervalo de administração e duração do tratamento farmacológico. Os dados obtidos dos prontuários e prescrições médicas foram tabulados para banco de dados Excel, separados em planilhas. A identificação e caracterização das interações medicamentosas foi realizada através do softwer Micromedex®, onde foi possível determinar e classificar as interações medicamentosas de acordo com a gravidade, início da reação e documentação existente. Com base nas monografias encontradas nas bases de dados ScienceDirect, PubMed Medline, Web of Science, SciELO e LILACS, as interações medicamentosas foram classificadas de acordo com o mecanismo provável e relevância clínica. Para a análise estatística dos dados coletados foi organizada uma análise descritiva construindo tabelas com as distribuições de frequências e porcentagens. Para análise de tempo de internação, número de medicamentos, número de interações e número de interações graves, os pacientes foram separados em dois grupos: idosos com idade entre 60 e 75 anos (Grupo 1) e idosos com idade igual ou superior a 76 anos (Grupo 2). A soma de postos de Wilcoxon foi utilizada para comparação. Utilizou-se o teste exato de Fisher para verificar associação entre os grupos e as variáveis gênero e comorbidades. O teste qui-quadrado foi utilizado para associação com o diagnóstico. Foi empregada a análise de regressão logística multivariada, para determinar os fatores associados à exposição à interação medicamentosa potencial. Também utilizou-se a análise de regressão logística multivariada, para determinar os fatores associados a exposição à interação medicamentosa potencial grave. O nível de confiança adotado para todas as análises foi 95%. A pesquisa foi desenvolvida respeitando-se todos os princípios éticos constantes da Resolução do Conselho Nacional de Saúde nº 466/12 sobre estudo envolvendo seres humanos.

Introduction: Crimes against sexual dignity have been a major problem in society for decades. Rape, one of these criminal modalities, has the highest incidence of female victims, victimizing different age groups and nations around the world. In Brazil, an annual average of half a million rape cases is estimated to be spread heterogeneously across the nation's territory. Forensic science is the branch of science that takes care of the investigation and application of the scientific method to elucidate the facts that permeate a criminal act, having in the expert's figure the central entity in the conduct and collection of evidence. Molecular biology techniques and methods of identifying human traces are extremely important for a sexual crime to be resolved, so that its outcome is the identification of the aggressor and the application of the appropriate penalty. Objective: to observe the influence of tissue types on trace samples of human semen as well as the feasibility of these samples to be subjected to molecular biology procedures for DNA extraction and quantification. Methodology: this is a descriptive, quantitative and experimental study, aiming at data collection through laboratory monitoring experiments. Semen samples were obtained through donation from participants willing to collaborate with the conduct of the study and the fabrics used to simulate the traces were clothes obtained through donation, 10 clothes being separated, 5 male and 5 female. The biological samples were processed using automated DNA extraction techniques with the Maxwell RSC Instrument equipment and quantified by RT-PCR with the aid of the QuantStudio 5 ™ equipment. As a presumptive test, the BiotesT® Quanti-Quali MedTest PSA immunochromatographic test was administered, a test designed to detect specific prostate antigen in the blood. Results: the PSA test applied as a presumptive test (orientation) was positive in 50 tests administered over 36 days of the spots, with an interval of one week between each test. DNA quantification proved to be efficient and applicable to tissues, demonstrating that molecular techniques that use automated extraction are applicable, have high sensitivity and low chances of contamination of samples by external DNA. Key-word: Forensic science; DNA; Biological evidence

Childhood cancer, which affects children and adolescents between 0 and 19 years, represents 1% and 3% of all malignant tumors in most populations, where it has been the leading cause of death (8% of the total) of the disease in this age group, the large number of long hospitalizations being notorious and consecutively, increasing the forms, qualities and abilities of providing care to this being. The objective was to understand the experiences lived by nursing professionals when providing care to pediatric cancer patients in an intensive care unit and its relationship with moral distress. This is an exploratory, descriptive research with a qualitative approach. Twenty-two nursing professionals, working in the Intensive Care Unit of the Children and Adolescent Hospital, located in the city of Macapá, participated in the study. For data collection, a questionnaire with semi-structured questions was applied to characterize the subjects, and interviews were carried out remotely, subsequently, and recorded with their authorization. Data analysis was performed with the support of the IRAMUTEC software and analyzed by the technique of Descending Hierarchical Classification, Similarity Analysis and Word Cloud, which were grouped and organized graphically according to lexical frequency. The words that had the highest frequency were: words "child", "care", "feel", "impotence", "resource", sadness. It was found that the care of pediatric cancer patients generates sadness, and lack of material and human resources, lead to a feeling of impotence, referring to the Moral Suffering of the subjects involved in the care. In this sense, it emphasizes the importance of investments in resources, materials, as well as research on this subject, contributing to the mitigation of moral suffering.

KEYWORDS: Psychological stress. Oncology. Pediatrics

The National Curricular Guidelines for the Undergraduate Medicine Course give greater autonomy to Higher Education Institutions, the Medicine courses, aim to build education that is geared to the health needs of the population, the public health system and to improve as its peculiarities. The adoption of active methodologies refers to teaching by skills, which should develop in the student the ability to recognize knowledge, attitudes and skills to be able to deal with real life situations, dilemmas and problems. Thus, student assessment becomes a fundamental part of this teaching-learning process. Knowledge about evaluation methods is an important teaching tool. A qualitative participatory study was carried out, which carried out the evaluation application through the Structured Objective Clinical Examination (OSCE / ECOE) to study the feasibility of its application for the Morphofunctional axis (basic cycle) of the Medicine course at the Federal University of Amapá, in order to exercise the clinical application of the content offered by these teachers of basic subjects, not accustomed to thinking about practical clinical situations, strengthening clinical reasoning since the beginning of the course. We chose to use the data collection technique called the Focus Group, to assess the perceptions about OSCE / ECOE by teachers and students who participated in the study. Categories were built, and separated into subcategories, between Positive points, Negative points and Proposed changes on the OSCE / ECOE. The evaluation was well accepted by the students who participated in the study, even though the positive points obtained the highest percentage of citations, there was a significant amount of citations in the negative points and proposed changes, in the positive points the main ones were about the relationship between the basic chairs and the medical clinic and emotional state, in the negative points about the lack of skill with the test and the waiting before it, the literature shows similar perceptions in this type of evaluation. In the teaching group, the percentage of citations for the positive points was more than double in relation to the negative points and more than triple for the proposed changes. In this group, the test was considered to have good potential for use, and it helps in the emotional state of the students, as positive points, whereas in the negative points it was considered a difficult assessment to organize / apply and prepare the clinical stations. The teachers' perceptions produced more negative categories, but the acceptability of this assessment was proportionally greater in this group.

Keywords: Medical education, assessment, problem-based learning.

In Brazil, little is known about the vasovagal reactions associated with blood donation, including the rates, severity and characteristics of donors. This study is a pioneer in the state of Amapá, a state in the Brazilian Amazon that has only one blood center, the Institute of Hematology and Hemotherapy of Amapá - HEMOAP, an exclusive supplier of blood components for all hospitals in the health network. Although blood donation is recognized as a very safe procedure, reactions of varying severity may occasionally occur during or after collection. It was proposed to assess the frequency and factors associated with vasovagal reactions in whole blood donors and to suggest practices that would help to minimize them. Through a descriptive, documentary, cross-sectional retrospective study of the records of reactions occurring between 2014 and 2018, an index of vasovagal reactions above the literature in general was found, averaging 3.1%, with variation between 2.4% and 3.8%; with a predominance of mild reactions (90.2%), more frequent in women (54.4%), aged between 30 and 40 years (33.8%). A statistically significant association was identified between milder reactions and a lower BMI, between higher VES and less severe reactions and between greater SBP and DBP and less severe reactions; in addition to milder reactions in individuals with lower HR, but without statistical relevance, and absence of a relationship between hematocrit rate and VVRs. First-time donors (63%) and those who made targeted donations (70%) experienced more VVRs. Statistically significant relationships were also identified between prolonged fasting and poor hydration and the occurrence of reactions. It was concluded that the profile of VVRs in donors of whole blood in the Hemotherapy Center of Amapá is similar to that identified in the literature, in most of the evaluated parameters. 

The snake-like accident is the picture of poisoning resulting from the injection of a mixture of toxins (raw poison or venom) through the snake inoculating apparatus. Ophidian accidents are considered a public health problem due to the incidence and intensity with which venomous animals act on human organisms, constituting the list of neglected tropical diseases. In Brazil, about 28,000 snakebites occur annually. The occurrence is related to climatic factors and increased human activity in field work. In the Amazon, socio-environmental factors such as hot and rainy weather, vegetation, rural housing and the urbanization process in peripheral areas of cities, are directly related to the considerable rates of snakebites. The problem is exacerbated by the long distances between the accident sites and medical care. For this reason, popular knowledge has been disseminated and practiced in snake accidents, in which, the use of medicinal plants, as adjuvants to serotherapy or as an alternative medicine is applied in the absence of serotherapy resources. The present study aimed to characterize the use of medicinal plants and the practices used in snakebites in riverside communities in the Municipality of Afuá-Pará (Maracujá Island, constituted by Furo do Maracujá, Riozinho and Canal do Vieirinha). It was held in a riverside community located on Ilha do Maracujá (Furo do Maracujá, Riozinho and Canal do Vieirinha), belonging to the municipality of Afuá-Pará-Brazil. The type of sampling used was snowball, that is, non-probabilistic sampling, which uses chains of reference, when it is not possible to determine the probability of selecting each participant in the research, useful groups that are difficult to access. A key informant was selected in the community for the start of the interviews, which helped to locate a total of 50 participants. When asked about the type of snake that caused the accident 82% said it was a jararaca (of the genus Bothrops sp.), Belonging to the family Viperidae. Regarding the anatomical region, most individuals had the lower limbs as the most affected region. Of the plant species used in the face of snakebites, the following were cited: Anacardium occidentale L., Annona muricata L., Manihot tripartita (Spreng.) Müll. Arg., Piper Peltatum L., Genipa americana L., identified by the herbarium of the Institute of Scientific and Technological Research of the State of Amapá. As for the most used methods in the face of snakebites, urine with clay was mentioned in the community of Furo do Maracujá; Specific Person in the community of Vieirinha and in the community of Riozinho. The riverside inhabitants maintain “homemade pharmacies”, supplied with herbal medicines; clay and stone containers; animal fat and bones; roots, bark, leaves, nuts and oils extracted from plant species in the Amazon. The knowledge of traditional medicine of the residents of Ilha do Maracujá is rooted in the process of colonization of the place, involving the coming and going of residents by the rivers of the region. Considering the problem caused by snakebite accidents, in distant regions in the Amazon (regarding the speedy treatment of anti-snakebite therapy), it is necessary to continue scientific studies on the biological action of medicinal plants used popularly in the treatment of snakebite accidents, for validation or not of the traditional knowledge of the inhabitants of the island of Maracujá, as well as to encourage bioprospecting research with the mentioned species.

Na Amazônia existe um grande poderio de plantas medicinais com os mais variados compostos e atividades, dentre elas podemos destacar a Almecegueira ou Breu Branco (Protium heptaphylum), uma planta encontrada na Amazônia, produtora de uma resina branco esverdeada que endurece em contato com o ar, popularmente utilizada por seus efeitos gastroprotetivos e anti-inflamatório. Na literatura encontram-se alguns metabólitos secundários obtidos através da resina de P. heptaphylum, entre eles uma parte considerável é uma mistura triterpenica de α e β amirina de onde podem-se obter uma série de derivados como formiato, acetato, benzoato e cinamato. O objetivo geral desde estudo é avaliar o potencial genotóxico e antigenotóxico em da mistura α, β-amirina obtida na resina de P. heptaphylum utilizando teste de micronúcleo em camundongos Swiss, administrando os animais com as dosagens 10mg/Kg, 3mg/Kg e 1mg/Kg, diluídas em DMSO 5%, e observando seus efeitos em esfregaços sanguíneos em 24h e 48h após o tratamento. Constatou-se que a administração dos compostos não ocasionou genotoxidade em 24h e 48h, em contrapartida antigenotoxidade foi, para as concentrações 10; 3 e 1mg/kg, respectivamente 67%; 12%; 10% em 24h e 73%; 15%; 9% em 48h.

The predominant model of childbirth assistance in Brazil is characterized
by the abusive or inappropriate use of obstetric interventions in all clinical periods of
childbirth. It is known that these interventions can be prevented or reduced with the
adoption of practices advocated by the National Guidelines for Assistance to Childbirth
of the Ministry of Health. This document is subsidized by the World Health
Organization, however, in our reality, most obstetric practices do not follows these
recommendations. The study aimed to evaluate the effectiveness of educational
interventions based on scientific evidence to improve the clinical practice of
obstetricians. This is a longitudinal, quasi-experimental study with nurses and doctors
who work in childbirth care at the Hospital Estadual de Santana, Amapá, Brazil, where
21 structured interviews were carried out in the pre and post-audit, in addition to
educational interventions with “audit and feedback” and “clinical practice guidelines”
recommended by Cochrane collaboration to bring about changes in the behavior of
healthcare professionals. In the interviews, a structured questionnaire with 29 questions
and five answer options on a Likert scale was used, ranging from “never” to “always”,
with a score from 1 to 5. In addition, 12 printed banners in the form of stickers,
measuring 120 x 90 centimeters, were fixed at the maternity reception and in the two
delivery rooms to reinforce the professionals to those recommendations of the clinical
practice guidelines. The study was carried out in three phases: pre-audit and (phase 1);
implementation of practices (phase 2, which corresponds to educational interventions);
post-audit (phase 3). The data were described and analyzed in a descriptive and
inferential way through the average ranking and total average ranking of the Likert scale
(by comparing the results of steps 1 and 3), with a significance level of 5%. The study
was approved by the Research Ethics Committee of the Federal University of Amapá
under opinion No. 2,853,419. The findings show that in relation to obstetric practices,
and according to the average ranking of the Likert scale, there was a significant increase
in the proportion of professionals who recommend or perform the perineal suture with
absorbable synthetic thread (p = 0.003) and the warm compress technique in the
perineum (p = 0.031). Regarding obstetric interventions, proportionally, there was a
reduction in the number of professionals who recommend or perform the Kristeller
maneuver in childbirth, with a statistical difference (p = 0.023). In the analysis of the
total average ranking, there was an increase in the proportion of professionals in favor
of recommending or performing obstetric practices, after the exposure of the banners, in
the comparison between phases 1 and 3, however, without significant statistical
difference (p = 0.230) and reduction proportion of professionals recommending or
performing unnecessary obstetric interventions, with statistical difference (p = 0.024),
between phases 1 and 3. It is concluded that educational interventions provided
improvements in the professionals' practice. We suggest new research with educational
intervention strategies that include multifaceted approaches to improve the quality of
evidence-based care in childbirth care.
KEYWORDS: Labor and Delivery. Normal birth. Clinical Audit. Translational Medical
Research.

Breast cancer is associated with numerous repercussions in the woman's life, from diagnosis to post-treatment, affecting an organ full of meanings. The purpose of this investigation is to evaluate the quality of life (QOL) of women with breast cancer who underwent mastectomy and to correlate it with the sociodemographic and clinical profile. Descriptive, documentary, transversal and quantitative study. The population consisted of 57 women attended at the High Complexity Unit in Oncology of Macapá-Amapá, from 2014 to 2018. The questionnaires QLQ-C30 and QLQ-BR23 were used at the interviewees' homes. For data analysis, the Statistical Package for Social Science (SPSS), version 24 Windows was used. The participants had an average age of 52.4 years, with a predominance of 82.5% of mixed race, 57.9% Catholic and 36.8% high school education, with the majority (49.4%) from the State of Amapá. As for the economic situation, 35.1% lived on two minimum wages, 57.9% did not work and 59.6% received Social Security benefits. With partners, they were 56.1%, and 75.5% had two or more children. 54.4% lived in residences with three or four people. The predominant type of surgery was total mastectomy, with 64.9% and lymphodectomy 70.1%. The average time to perform the surgery was two years and one month and the therapy most associated with the surgery was chemotherapy (73.6%), however, 82.5% did not undergo breast reconstruction. Multiprofessional follow-up: 71.9% were assisted by a nutritionist, 57.9% psychologist and 84.2% physiotherapist. QL characterization: in the QLQ-C30 instrument, there was a moderate global QOL of 62.3 ± (19.6). Most affected domains: performance of functions 55.6 ± (31.2), emotional function 61.3 ± (32.4) and cognitive function (62). Most common symptoms: financial difficulties, due to 64.9 ± (33.6), pain 38.6 ± (28.2) and fatigue 35.1 ± (28.7). In the QLQ-BR23, there was a decrease in sexual function 21.1 ± (21.5), sexual satisfaction 42 ± (23.7) and prospects for the future 49.1 ± (37.3), indicating a tendency towards QoL impairment. The symptom scale was low, the most common were hair loss 34.7 ± (33.3) and symptoms in the breasts 33.5 ± (30.0). Young mastectomized women had worse scores on the functional scale related to body image (p: 0.004); there was a significant association of women with a partner and sexual function (p = 0.024), with a tendency for better QOL for those without a partner, and the financial toxicity caused by the treatment was greater among women with low income (p = 0.004). Quadrandectomy was significantly better in physical functions (p = 0.024) and function performance (p = 0.015), compared to total mastectomy, which presented greater financial difficulties related to treatment (p = 0.006). Women with breast reconstruction had better sexual function (p = 0.028) compared to those who did not perform it. In turn, length of surgery, follow-up with a psychologist and physiotherapist had no significance level. Thus, the participants presented moderate QOL when QLQ-C30 was applied and great compromise in QLQ-BR23, especially in sexuality.
Keywords: Quality of life. Breast neoplasm. Mastectomy.

Introduction: Acmella oleracea (L.) R. K. Jansen, popularly known as Jambu, is a plant widely consumed inthe Brazilian Amazon region. Several pharmacological effects are attributed to them, being used in traditional medicine to treat dental caries and toothache. Objective: Determine the phytochemical profile of the aqueous and ethanolic extracts of the Pará and Amapá variants of Acmella oleracea (L.) R. K. Jansen and evaluate their bactericidal and antibiofilm activity against Streptococcus mutans. Methods: Aqueous extracts of the leaves and ethanolic extracts (70%) of the leaves and stems of the two regional variations were obtained, all were qualified and quantified by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-ESI-QTOF-MS/MS). The minimum inhibitory (MIC) and bactericidal concentration (MBC) using the 96-well plate microdilution method and a biofilm viability test against Streptococcus mutans were performed. Results: The aqueous extracts showed a better overall yield compared to hydroethanolic, the samples of aqueous leaves extract of Amapá (EBA FolAP) and Pará (EBA FolPA) variations obtained an overall yield of 41.1% and 84.8% respectively, values 1.6 and 5.3 times higher than the same plant part in a hydroethanolic solvent. On the other hand, the hydroethanolic solvent ensured a batter spilanthol extraction. The hydroethanolic samples of leaves (EBE FolPA) (99.97%) and stem (EBE CauPA) (98.83%) from Pará, as well as leaves (EBE FolAP) (96,10%) and stem (EBE CauAP) (99,17%) of Amapá regional variation, showed higher spilanthol percentages when compared to EBA FolPA (93,98%) and EBA FolAP (96,10%). The samples with the highest spilanthol concentration (EBE FolPA and EBE CauAP) were selected for antimicrobial assays. Microbiological tests showed that both samples had MIC and MBC of 125 μg/mL against S. mutans. In the antibiofilm assay, the EBE FolPA sample with 4x and 8xMIC concentration, as well as the EBE CauAP sample with 16xMIC concentration obtained a statistically similar inhibition (p<0.05) to chlorhexidine. Conclusion: The EBE FolPA and EBE CauAP samples showed a potent inhibitory and bactericidal activity against S. mutans, in addition to an antibiofilm action similar to chlorhexidine (EBE FolPA sample in 4xMIC concentration). Further analysis of the action of these extracts against intraoral bacterial biofilm is needed, however, this plant can be seen as an affordable and low-cost source of phytopharmaceuticals to act against diseases of the oral cavity, whether in the control of caries or as an adjunct to existing dentifrices.
Keywords: Acmella oleracea; Spilanthol; UHPLC, Streptococcus mutans; Dental caries

Os insetos denominados flebotomíneos têm importância médica por serem os vetores de Leishmanioses. Esses insetos pertencem à Ordem Díptera, Família Psychodidae, Subfamília Phlebotominae, e são conhecidos popularmente, dependendo da localização geográfica, como mosquito palha, tatuquira, birigui, entre outros. Os flebotomíneos tem distribuição diferenciada no território brasileiro e no mundo. A diversidade de espécies de flebotomíneos, bem como a composição de uma comunidade, são resultados de interações ecológicas e aspectos geográficos locais. Desta forma, alterações no ambiente afetam a dinâmica das populações de flebotomíneos, alterando sua composição, seus hábitos e o comportamento das diferentes espécies, assim como a sua capacidade vetorial. A identificação de uma espécie vetor e a identificação da taxa de infecção natural, principalmente nas regiões endêmicas, é de fundamental importância na entomologia médica. Esta pesquisa visa determinar o padrão de distribuição das espécies de flebotomíneos nos municípios do Estado do Amapá, através do sequenciamento da região do gene COI (Citocromo Oxidase Subunidade 1) do DNA mitocondrial e determinar o método de PCR-RFLP desenvolvido para identificação dos vetores, e ainda relacionar as espécies coletadas nos 16 municípios do estado do Amapá com o ambiente no qual foram encontradas, criando um panorama a respeito dos locais onde há a presença de Flebotomíneos. Com o uso de armadilhas CDC, os flebotomíneos foram coletados nos 16 municípios do Estado do Amapá no período de junho a agosto de 2017. Após a coletas, as amostras foram submetidas ao processo de triagem e extração de DNA. As amostras tiveram seu DNA extraído e uma região de 700 pares de base foi amplificada dentro da sequência do gene COI. Os produtos de PCR serão sequenciados, e o banco de dados gerado será utilizado como modelo para estabelecimento de metodologia de PCR-RFLP que permita a rápida e com custo acessível identificação das espécies de flebotomíneos. Como resultado foram coletadas 599 Flebotomíneos, sendo 340 fêmeas e 259 machos.Após amplificação da região do gene COI do DNA mitocondrial, foi possível obter 332 amostras amplificadas, o que representa 55,43% do total de flebotomíneos coletados. Estas amostras serão enviadas para sequenciamento por empresa terceirizada.Esses resultados mostram que o tamanho amostral e a técnica utilizada no presente estudo apresentam perspectiva de elucidar a identificação dos espécimes coletados, e o desenvolvimento de metodologia de RFLP com os dados obtidos em conjunto com os

Photodynamic Therapy is the interaction of a photosensitizer with a light source of specific wavelength and oxygen. This photochemical interaction causes cellular destruction of microorganisms by oxidative stress. Intensive care patients are highly likely to develop infections and die. Such infections are often related to pathogens present in the oral microbiota. The objective of this study is to evaluate the effect of photodynamic therapy on oral microorganisms in patients admitted to an intensive care unit. Three collections of saliva sample were performed in the research: The first performed in the first 24 hours of hospitalization of the patient, called c0. Collections c1 and c2 were performed 48 hours after the first collection c0, respectively, before and after the intervention. Participants were randomly allocated in two research groups that determined the intervention performed. Participants allocated to the experimental group, photodynamic therapy was applied in a single session in the oral cavity in the region of the retromolar trigone, with irradiation of red laser and methylene blue 0.5% for 1.5 minutes. Participants allocated to the control group, methylene blue was applied to the retromolar triangle without laser irradiation. The samples collected in the hospital were transported to the laboratory within 2 hours of collection for counting Colony Forming Units and microorganism identification. This research was approved by the Research Ethics Committee of the Federal University of Amapá - UNIFAP number 2.349.365 and registered in the Brazilian Registry of Clinical Trials - ReBEC: 6VZH6P. The media with the samples from the c1 collections showed, on average, a greater number of CFU than the media with the samples from the c0 collections; therefore, there was a numerical increase of microorganisms in the patients' oral microbiota after 48 hours of hospitalization. There was a statistically significant difference between the CFU numbers of the samples collected before and after PDT (respectively c1 and c2), it is suggested that PDT acted in the reduction of oral microorganisms of patients hospitalized in ICU approximately 78.6%. The number of CFU of the samples referring to collections c1 and c2 of the control group did not present a statistically significant difference, thus, the methylene blue in the concentration used without the irradiation of light did not present antimicrobial activity. It was identified in the oral fluid samples: Pseudomonas aeruginosa, Proteus spp, Klebsiella spp, Escherichia coli, Coagulase negative Staphylococcus, Staphylococcus aureus, Streptococcus spp and Candida albicans. Photodynamic therapy is able to reduce the oral microorganisms of patients hospitalized in ICUs, therefore, it is possible to use this therapy as an alternative or to assist oral decontamination, reducing the possibility of developing infections.
Keywords: Methylene blue. Hospital Infection. Colony Forming Unit. Oral microorganisms.

The search for quality of life through sports has grown worldwide, among the various options Cross Training emerged, which followed the same principles as CrossFit, both can be considered a form of high intensity functional training. The number of Cross Training practitioners in Brazil has increased in recent years, and it is possible to observe this growth also in the city of Macapá-AP, with this popularity, questions arise about the benefits in improving the quality of life and possible risks to the health of their practitioners, since research exploring this topic is still scarce. Objective: This study aimed to characterize the epidemiological profile of Cross training practitioners in the city of Macapá. Material and Methods: A field research was carried out, using a non-experimental type of exploratory-descriptive nature, with a cross-sectional approach, and a quantitative approach. The answers were obtained through a questionnaire that sought to explore the socioeconomic, sociodemographic profile, aspects related to the practice and the incidence of pain and injury. Results: The sample comprised 185 Cross Training practitioners, 66.5% women and 33.5% men, with an average age of 31.1, ± 7.06 years; the predominant color / race was brown (55.7%); single marital status (66.5%), higher education (77.8%) and income between 3 to 5 minimum wages (40.8%). With regard to practice, 80.0% trained daily for up to 1 hour, weekly frequency was 5 to 6 times (75.1%); practice time of up to 6 months (37.3%). About 53.0% performed other physical activities and 33.5% participated in competitions. The injury rate was 33.0%, with muscle strain as the most common (69.1%), the lumbar region most affected (33.0%), there was a search for a professional to treat the injuries. in 77.0% of cases. The appearance of injuries was shown to be significant when associated with higher weekly frequency (p = 0.010) and time of practice (p = 0.002) and also among competitors (p = 0.005). Final Considerations: The higher the weekly frequency and time of practice, the greater the chances of developing injuries, as well as participation in competitions was a relevant aspect for this outcome.

Keywords: Physical Training. Epidemiological Profile. Sport injuries. Human Physical Conditioning.

Systemic arterial hypertension is the most common cardiovascular disease and responds as the main risk factor for the most common complications such as stroke and acute myocardial infarction, besides terminal chronic kidney disease. Health education is the main tool for changes in habits and lifestyle, fundamental in the preventive process of hypertension. Thus, this research aimed to evaluate the impact of health education actions developed within the Amapá Court of Justice on the risk factors for systemic arterial hypertension. The study was descriptive, with quantitative approach, survey procedure, using the questionnaire as a data collection instrument, with the participation of 255 servers of the Court of Justice of the State of Amapá. This study was approved through Opinion No. 2,955,665, following the recommendations of Resolution No. 466/2012 of the National Health Council - CNS. The collected data were tabulated by double digitization, for comparison and validation of the database. Data analysis was performed using the Statistical Package for Social Science SPSS version 22 (IBM SPSS, USA) to perform univariate and bivariate statistical analysis of variables. Descriptive analysis showed frequency distribution between sex and socio-demographic variables, physical and clinical data. In the inferential analysis, Pearson's chi-square test (χ2) was used to analyze the association between hypertension and socio-demographic variables, physical and clinical data, habits and lifestyle, chronic diseases and health status and health education. Α = 0.05 was used in all tests. The results showed that 54.1% were female, 66.3% brown, 33.7% aged 40 to 49 years old, 47.8% had higher education and 59.6% were married or lived. in stable union. The Body Mass Index showed that 48.2% were overweight, 64.7% had increased abdominal circumference, 10.6% had capillary blood glucose values ≥ 99 mg / dL. Regarding blood pressure, 33.3% of men and 21.7% of women had BP ≥ 140 and / or 90 mmHg. Regarding participation in some preventive or educational activity, 76.1% said yes, 60.4% considered it satisfactory and 44.7% did not influence changes in lifestyle. As the result proves that health education actions are partially impacting the risk factors for systemic arterial hypertension in the judiciary workers, as the risk factor indices still cause concern.

Mental disorders can affect children when external or internal situations change their behavior, directly or indirectly interfering with their psychological development, thus affecting their interpersonal relationships and their school performance. Therefore, early identification of children at risk of developing a mental disorder will allow early intervention, minimizing family suffering and making health and education professionals more vigilant. The most common psychopathological symptoms in childhood such as depression, anxiety disorders, attention deficit hyperactivity disorder, substance use disorder, conduct disorders and eating disorders. The aim of this research is to analyze psychopathological symptoms and associated factors. to them. This is a cross-sectional and exploratory study with a mixed approach (quantitative-qualitative) that will have as data collection instrument the Identification Scale of Psychopathological Symptoms in School (EISPE) and a sociodemographic questionnaire prepared by the researcher. For data analysis, descriptive and analytical analyzes were performed using the statistical program SPSS version 22.0. Qualitative data were analyzed using IRAMUTEQ software and content analysis. The research was conducted in the municipality of Ferreira Gomes-AP developed in two municipal and one state schools that cover the initial grades of elementary school. The project audience was 178 children aged 6 to 12 years enrolled in the municipal and state schools of Ferreira Gomes. Regarding the age group, most children were between 9 and 11 years old (64.0%), male (54.5%), born in the city of Macapá (62.4%), enrolled in the 3rd and 4th grade of elementary school (52.3%), family income less than one minimum wage (65.2%), unemployed responsible (66.9%), with social benefit (51.7%), without having moved house Due to the construction of the hydroelectric dam (83.1%), the construction of the hydroelectric dam did not bring benefits to the family (82.0%), no family member in psychiatric / psychological treatment (87.6%), no people close to the child alcohol / drug abuse (79.2%), and children who perform physical activity (79.2%). The most common psychopathological symptoms were related to conduct and attention. In the textual corpus resulting from the frequency of the students' speech, processed and analyzed by the IRAMUTEQ software, the words “sad”, “worried”, “fat”, “fear” and “father” were the most frequent. It concludes about the need for mental health promotion activities of these children and their families, including in the school environment, in order to reduce the risk factors related to the mental health of children and their families. 

Vision is very important for child's development. The number of visually impaired people in Brazil and worldwide, financial, social impacts of this deficiency are alarming, the percentage of low-income population is large and the preventive actions related to ophthalmological problems are very important. Investigating the knowledge and practice of professionals who work in the Family Health Strategy on childhood eye health is important in order to evaluate whether, in fact, the recommendations from Ministry of Health since 2013 have been followed, to the vision for the population. Objective: To develop and validate the Scale of Knowledge and Practice on Ocular Health in Childhood for Professionals of the Family Health Strategy. Method: The scale was elaborated based on the Directives of Attention to the Ocular Health in the Childhood - 2nd edition. It consists of 13 questions, with responses categorized as Likert-type scale, related to the identification of risk situations for prenatal and child eye health and appropriate intervention, functional assessment of vision, signs and symptoms related to ocular health and gauging of visual acuity. To validate the clarity and content of the instrument, the scale items were presented to a multidisciplinary team of 9 professionals with ocular health experience and the agreement percentage was analyzed. The instrument was also submitted to the pilot test and applied to 30 professionals of the target population. The degree of agreement between them was evaluated by calculating the Content Validity Index (CVI). The construct validity was verified by the internal consistency analysis, analyzing the items by the Rash Model and the Cronbach's alpha calculation in a sample of 150 people. Results: In the validation of content, all items had concordance percentage greater than or equal to 80% by the judges. In the CVI analysis, during the pilot test, all items were maintained. The internal consistency analysis presented Cronbach's alpha of 0.556 for the Knowledge subscale and 0.778 for the Practices subscale and in the item-by-item analysis none of the items undermines this subscale. Considering the full scale, the alpha is 0.684, showing good internal consistency. The Rasch model analysis demonstrates that the scale is valid, the subscales are one-dimensional and no item distorts the measurement. Conclusion: The scale of childhood eye health knowledge and practices for family health strategy professionals has been successfully developed, presenting content and construct validity. Keywords: Ophthalmology. Eye Health. Family Health Strategy. Child. Validation Studies

With significant advances in the field of environmental virology, enteric viruses have been recognized as the causative agents of many cases of diseases and outbreaks from contaminated sources of water for consumption, considering the environmental persistence of these agents and the resistance they present to conventional water treatment. This study aimed to detect the presence of enteric virus, total coliforms and Escherichia coli in water from wells in the city of Macapá-Ap due to detection of enteric virus by means of molecular analysis. Samples were collected between November 2016 and March 2017, 2L of water were collected monthly in 16 neighborhoods of the urban area of the city. Three types of virus (Adenovirus, Rotavirus and Norovirus) were analyzed. The viral concentration was performed by the HA membrane adsorption-elution method, followed by reconcentration by ultrafiltration in Amicon Ultra-15. A commercial Qiagen kit was used to obtain viral DNA and RNA. For molecular detection, the Polymerase-Mediated Chain Reaction (conventional PCR) and real-time PCR were used for the detection of norovirus. The positive products of the water samples were submitted to nucleotide sequencing and compared to others obtained in a data batch (GeneBank). Quantification of total coliforms and Escherichia coli were also determined by culture (Colipaper). Human Adenovirus DNA was detected in 152/256 (59.38%) of the samples. Phylogenetic analysis showed that the environmental isolates of this study belonged to species F, subtype 41 (characterized as enteric adenovirus). The high similarity with Brazilian sequences evidences the endemic circulation of HAdV isolates in Brazil. No samples were positive for Norovirus and Rotavirus. The concentrations of total coliforms and E. coli exceeded in every month the limits established by the Ministry of Health (ordinance no. 2914/11). The logistic regression analysis showed that there was no association between the presence of HAdV and the bacteriological parameters of the water. The results obtained evidenced the circulation of enteric viruses in this region, providing additional information on the molecular epidemiology of HAdV in Brazil, as well as the high level of microbiological contamination of the groundwater of the city of Macapá, resulting from the deficient basic sanitation service.

The psychiatric reform made possible a new configuration in the assistance action, creating substitutive models to the asylums and psychiatric asylums, composing a new scenario of mental health policies for people in psychological distress. Among these policies is the implementation of Psychosocial Care Centers (CAPS), which addresses different profiles of people with severe and persistent mental disorders. This study aimed to describe and evaluate a Type III Psychosocial Care Center in Macapá, based on the coordination, technical staff, users and family members. An exploratory, quantitative and qualitative research was conducted. The study sample included 1 CAPS coordinator, 15 workers, 40 users and 20 family members of CAPS III users, in Macapá, Amapá. It had as research tool questionnaire, interview and observation notes. The questionnaire was directed to the coordinators and professionals of the service, and this instrument was adapted and originally based on the mental health professionals' satisfaction rating scale, which assesses the degree of satisfaction of mental health professionals. The interviews were directed to users and family members, by applying the SATIS-BR scale in the abbreviated version. The results showed that the physical structure of CAPS III was the most prevalent negative item in the participants' evaluation, with few advances in working conditions, but there was a prevalence of positive evaluations in the other items evaluated. The evaluation of the subjects pointed out that the service needs investments in physical structure, ambience, professional qualification and working conditions, which directly interfere in the care of users. It is noteworthy that there was a prevalence of positive evaluations, with a satisfaction average of 4, except for the factor physical conditions and comfort of the service, which received a score of 2.08 by users, which correlated with the evaluation of professionals and family members. Considering the global scale, there were high levels of satisfaction of the factors evaluated by users and family members. This may be an indication that practitioners seek to offer a good reception, good treatment results, privacy and confidentiality, but survey participants still recognize that the service needs improvement. Therefore, the results indicated that CAPS III offers territorial care in mental health, with assistance focused on psychosocial reintegration, albeit with fragility. The actions of the service must ensure quality and other rights won by the Brazilian psychiatric reform.

Chronic diseases are a global health problem and are considered a threat to human health and development, especially in developing countries. Cardiovascular diseases are the main causes of death in Brazil, and are related to multifactorial situations. The main risk factors for these diseases are hypertension, dyslipidemia, smoking, alcoholism and diabetes. Objective of the study was to analyze risk factors for cardiovascular disease in motorcycle taxi drivers. The research is descriptive, exploratory, quantitative approach, and cross-sectional. It used a convenience sample, a 5% sample interval and a 95% level, a sample consisting of 274 motorcycle taxi drivers. A questionnaire with closed questions was used that included sociodemographic aspects, working conditions and health, anthropometric data. The data collected were tabulated Microsoft Office Excel version 2010, analyzed in the SPSS program (Version 22.0), was used in absolute and relative frequencies, continuous data in mean and standard deviation, the Spearman correlation Kolmogorov-Smirnov test used square, logistic and Fischer exact regression. According to the results, 274 motorcycle taxi drivers with an average age of 41.1 years were evaluated. 98.9% (271) are adults aged ≤ 60 years, 54% reported being brown, 45.6% complete high school, 42.3% have marital status of stable union, 12.4% reported Systemic Arterial Hypertension, 8% use some medication, 86.5% (237) do not smoke, 51.8% (142) drink alcohol, 83.6% (229) have 4-8 hours of sleep and rest daily, 60% (170) of the participants eat 4-6 meals, 69.9% (167) do not consume canned / inlaid, consume 86.1 % (236) fruit and vegetables and 96% (263) eat beans regularly, fried foods 86.1% (236), sweet foods 68.9% (188), fat meat 78.8% (216), soda and / or artificial juice 66.8% (183), do not exchange the meal for snacks 68.6% (180), do not perform physical activity / exercise (a) 69.2% (189), perform their work activity in both morning / afternoon shifts 59.1% (162), executi daily work in ten hours or more 55.8% (153), are permission-holders 77.7% (213), BMI averaged 29.18, overweight 45.7% (125), obesity 37.2% (102), 71.1% (n = 195) with waist circumference measured above ≥94cm, 80.6% (221) with WHR above> 90, 35.4% (97) had high blood pressure. Significant association was found in Religion (p-value: 0.000), Marital Status (P-value: 0.005) and Alcohol consumption; region (p-value: 0.046), marital status (P-value: 0.013) and hypertension; Region (p-value: 0.000) with diabetes and dyslipidemia; Southeast and Midwest are, respectively, 3.6% and 2.4% more likely to have diabetes than those from the North; physical activity / exercise practice (a) (p-value: 0.000) and waist / hip ratio; physical activity / exercise (a) (p-value: 0.000), type of activity (p-value: 0.001) and waist circumference; fried foods (p-value: 0.040) and waist / hip ratio; working hours (p-value 0.030) and waist circumference; working hours (p-value 0.000) and RCQ. This study reinforces the need for health promotion and disease and health prevention measures to reduce exposure to risk factors and improve the quality of life of motorcycle taxi drivers in Macapá.

Chronic Myeloid Leukemia (CLM) is a myeloproliferative neoplasm of clonal origin, resulting from the transformation associated with the genetic condition called Philadelphia chromosome, which results from the translocation of chromosomes 9 and 22 (t9,22). The first line of medications for CML is the tyrosine kinase inhibitor named Imatinib, however, about 25% of patients did not respond to treatment, which led to the development of second generation inhibitors such as Dasatinib and Nilotinib, and third generation, such as Bosutinib and Ponatinib. Genetic differences in metabolic pathways may affect individual responses to drugs in terms of therapeutic and adverse effects, being the subject of a Pharmacogenetic studies. The objective of this work was to investigate the alelic distribution of polymorphisms in the SLCO1B1 gene in 20 patients with CML treated with Imatinib in Dr. Alberto Lima Clinics State Hospital, Amapa, Brazil, and to verify if the genotype presented by the patients is associated with treatment response. For this, samples of peripheral blood and buccal cells were collected, DNA isolation according to the specificity of each sample and genotyping of allelic discrimination polymorphisms was performed using TaqMan OpenArray Genotyping technology and statistical analysis was performed using the chi-square test. The epidemiological profile of the patients showed a higher incidence in men than in women, the median age at diagnosis was 38.5 years and the median duration of treatment was 3.5 years. No statistical significance was found for the polymorphisms investigated in this study. The importance of pharmacogenetic studies in mixed populations, such as the Brazilian population, is highlighted, since few studies are performed and little is known about the influence of population genetic composition on the treatment of patients with various types of drugs.

Keywords: Leukemia. Pharmacogenetics. Imatinib.

At the present time, there is a cult of the body, especially on the part of adolescents, regarding the issue of thinness associated with a right to food. Objective: To correlate the factors associated with the perception of the body image and the physical activity practice of the high school students of Public Schools of Macapá. Methods: This is a field study with 357 adolescents from the High School of Public Schools of Macapá, with a quantitative approach. The questionnaire questions were evaluated through questionnaires, through a body image evaluated through the body shape questionnaire (adapted), a questionnaire with 34 questions to investigate body image. the level of physical activity was self-reported in comparison with levels of physical activity (QAFA). of adolescents. Adolescents classified as physically inactive adolescents, who did not reach ≥ 300 min / week of physical activity, performed physical activity. In addition, weight and height were measured during the procedure. The independent variables of the study were evaluated through the Brazil Criteria and a part of the AAQ that addresses the perception of health and social support. This research was carried out by the Research Ethics Committee of UNIFAP. Results: The prevalence of no image distortion was identified in adolescents, and 70.87% (n = 253) of the sample between boys and girls did not distort body image, with 83.85% (n = The adolescents' health perception ranged from good to fair with 43.54% (n = 112) and 31.46% (n = (N = 112), with infants more physically active (52.65%, n = 129) than girls (47.35%, n = 116) ) Initial conclusions: The results showed a higher prevalence of physically active adolescents with no distortion of body image, more than half of the students were classified in socioeconomic classes B2 (31.37%; n = 112), C2 (17.65; n = 63) ) and C1 (17.37%, n = 62). Body image distortion was more prevalent among females with 21.29% (n = 76); girls also had a higher prevalence of those that did not reach the recommended minimum for this age group, reaching 71.43% (n = = 116). The results may be associated with various social factors including social, economic, demographic, and cultural factors

A ingestão de alimentos contaminados por microrganismos causam diversas doenças e constituem um grave problema de saúde pública. O pescado é um dos principais alimentos que serve de veículo na transmissão de agentes patogênicos, destacando-se Listeria monocytogenes e Salmonella spp., que é apresentado como o principal responsável por óbitos relacionados com doenças transmitidas por alimentos, e como o agente bacteriano mais envolvido nos surtos alimentares, respectivamente. O objetivo deste estudo foi avaliar as características microbiológicas e higiênico-sanitárias do salmão (sashimi) comercializado em restaurantes especializados na culinária japonesa da cidade de Macapá, Amapá. Foram coletadas 20 amostras em duplicatas provenientes de 10 restaurantes e submetidas a protocolos microbiológicos com base na Instrução Normativa nº 40, de 16 de dezembro de 2005 do Ministério da Agricultura, Pecuária e Abastecimento, para identificação de Listeria monocytogenes, e conforme o Manual de Métodos de Análises Microbiológicas de Alimentos para o isolamento de Salmonella spp. Os parâmetros higiênico-sanitários em menor conformidade foram descritos de acordo com a lista de verificação padrão da vigilância sanitária municipal e a temperatura das amostras mensuradas utilizando termômetro digital com mira infravermelha. Do total de amostras analisadas, nenhuma apresentou contaminação por Listeria monocytogenes. Já Salmonella spp. foi isolada em amostras de quatro (40%) restaurantes. A categoria que apresentou itens em menor conformidade foram os parâmetros higiênico-sanitários associados aos manipuladores, destacando-se o aspecto da higienização das mãos e o risco de contaminação cruzada insatisfatório em 100% dos restaurantes avaliados. Os valores referentes à temperatura das amostras variaram de 1.0 a 22ºC, em que 80% das amostras apresentaram valores acima dos recomendados pela legislação brasileira (≤ 5ºC). Estes resultados evidenciam que as amostras analisadas representam risco à saúde do consumidor, comprometendo sua segurança alimentar e nutricional, considerando a associação de parâmetros higiênico-sanitários insatisfatórios de manipuladores, temperatura inadequada e isolamento de Salmonella spp. Portanto, a aplicação de boas práticas de manipulação nesse tipo de estabelecimento torna-se fundamental para evitar doenças e transtornos de origem alimentar.

Atividade Física é caracterizada por todo movimento corporal que eleve o gasto energético acima dos níveis de repouso. A atividade física insuficiente é considerada o quarto maior fator de risco para mortalidade global.  Estima-se que no mundo 81% dos adolescentes são considerados insuficientemente ativos. Meninas apresentam maior nível de atividade física insuficiente que meninos. O tempo de tela é uma das formas mais utilizadas na literatura nacional para avaliar o comportamento sedentário. O tempo gasto em comportamentos sedentários pode substituir o tempo em atividade física. Revisões sistemáticas sobre o tempo de tela indicam alta prevalência de exposição em adolescentes, mas não medem a exposição ao celular. Poucos estudos o têm associado ao nível de atividade física. Objetivo: Analisar a associações entre o nível de atividade física, o tempo de tela e fatores sociodemográficos de adolescentes de escolas públicas de Macapá. Métodos:  Estudo de campo com 525 adolescentes de 15 a 18 anos de escolas públicas de Macapá, com uma abordagem quantitativa. O tempo de tela foi identificado através das perguntas sobre o tempo que o adolescente passou por dia, em média, de segunda a sexta e no sábado e domingo dos últimos sete dias assistindo televisão, usando o computador/videogame e celular, contidas no Questionário de Fatores Associados à Atividade Física. Foi utilizado o ponto de corte de duas horas para estabelecimento de variáveis dicotômicas. O nível de atividade física foi medido através do Questionário de Atividades Físicas para Adolescentes (QAFA), que mede o nível de atividade física através de perguntas sobre a realização e o tempo engajado em 24 práticas corporais, sendo possível que o adolescente acrescente duas atividades que não estejam no questionário. Foram considerados fisicamente ativos os que alcançaram a soma igual ou maior que 300 minutos por semana. O Critério Brasil e o QFAAF foram utilizados para medir as variáveis sociodemográficas. Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da UNIFAP. Resultados: Obteve-se a prevalência de atividade física de 67,6% (n=355).  A prevalência de exposição ao tempo de tela acima de duas horas de 90,9% (n=477) nos dias de semana. Nos fins de semana, a prevalência foi de 88,8% (n=466). A classe econômica predominante na amostra foi a classe alta (55,7%; n=292). O nível de atividade física foi associado ao sexo. O tempo de tela total foi associado ao sexo e ao nível socioeconômico. Não houve associação significativa entre atividade física e tempo de tela. Considerações finais: A alta prevalência geral de atividade física ocorreu pelo aumento da prevalência em meninas. O celular foi o aparelho ao qual o adolescente mais se manteve exposto. A prática de atividade física pode coexistir com elevado tempo de tela, principalmente do celular. O tempo de tela pode e deve ser utilizado como apoio para a prática de atividades físicas. As famílias devem estabelecer seus próprios limites para o uso das telas. Estudo futuros devem utilizar métodos mais refinados para avaliar o comportamento sedentário em adolescentes.

Introduction: hospitalization of children requires an interruption of their daily environment, altering their habits and their capacity for self-actualization and self-care, being characterized by abrupt insertion in another space, before the school, now the hospital. Objective: To analyze the challenges of schooling of hospitalized children that interfere in the continuity of studies from the family and school perspective. Methodology: This is a descriptive, exploratory, documentary and qualitative study, developed at the Child and Adolescent Hospital of Macapá and in Educational Institutions. The subjects of the research were 25 relatives of children hospitalized for more than five days, in the age group between 9 and 12 years and 29 pedagogical coordinators of the schools in which these children were enrolled. Data collection was done through a checklist applied to medical records and interviews with family members and pedagogical coordinators. Data analysis was carried out with the support of the IRAMUTEQ software, in which the Hierarchical Descending Analysis, Similitude Analysis and Word Cloud were performed. The interpretation of the results approached the Theory of Social Representations. The study was submitted to the ethics committee obtained opinion nº 2,546,047. Results: predominantly male children (56%), with more than 11 days of hospitalization (68%), and previous hospitalization (64%), due to respiratory causes (32%), 48% of them with chronic conditions of health. All enrolled in public schools. As for family members, 96% were female, 76% mothers of children, all of low income (up to 2 minimum wages). Most of the pedagogical coordinators were female (17.25%), pedagogues (75.86%), with specialization (79.31%); 75.86% worked exclusively in the pedagogical coordination of the school and 55.17% had been in this position for more than five years. The analysis of the textual corpus of both groups of interviewees evidenced absence of educational care in the hospital, although both pointed out, the great representativeness of the same for the recovery of the child's health and continuity of their schooling. The descending hierarchical analyzes showed six classes that show teaching and learning as an integral part of the social representations of family and pedagogical coordinators. Considerations: the findings show that among the challenges of schooling of hospitalized children are questions related to the pathology itself and its treatment, its low socioeconomic status, which contributes to illness, hospitalization and, consequently, school withdrawal, absence of educational activities in the hospital environment, absence of a pedagogue inside the hospital, which shows the lack of communication between the health and education sectors. As positive representations it was evidenced that the existence of hospital education could provide greater adherence of the child to the treatment, increase of their self-esteem, besides being a learning and continuation of their schooling. In order to do so, it is necessary the integrity between the health and education services, so that the legislation is complied with and institute the school attendance to hospitalized children.

Widely distributed in Central America, South Africa and Asia, an Annonaceae family is composed of about 130 genera and 2300 species, among which are Annona, made up of 118 species where 13 are producers of edible fruits, being the most representing Annona, Duguetia, Guatteria and Xylopia. The genus Annona has acetogenins with properties in the literature as for the treatment of Diabetes mellitus, insomnia, combat to cancerigenic, among others. Therefore, the present study should evaluate the genotoxic and antigenotoxic potential of Annona monticola in cells of Swiss mice. The animals were treated with A.monticola solutions: 50, 100, 200 and 400 mg / kg p.c., and compared with the control (doxorubicin, DXR, 15 mg / kg p.c) and negative (water) groups. They will be administered to the animals via gavage, as well as the negative control, and the positive control will be administered intraperitoneally. The micronucleus test in peripheral blood will be done by counting 3,000 polychromatic erythrocytes per animal of each proposed group. A cytotoxicity will be assessed by the nuclear division index (IDN). This object was to validate the effect of the anti-toxicological and / or antigenotoxic effects of the age of the population.

The preventive dental care, through recurrent visits of the patient to the office, aims to conserve the oral cavity in ideal conditions, in order to reduce the risk of generalized oral infections. Several methods of supragingival plaque control can be used to guarantee the health of the dental structure and oral mucosa of the oral cavity, among which the use of the chlorhexidine digluconate in the concentration of 0.12%. It is known that the use of oral antiseptics as a frequent measure of oral hygiene has controversial efficacy since, although they have an effectiveness in the control of several pathogenic bacteria, they may present a genotoxic potential in the buccal mucosa epithelium in the individuals that make use of this substance. This study aimed to verify the effects of 0.18% nanoencapsulated chlorhexidine on the mucosa of the oral cavity by investigating the influence of this substance on the oral epithelium and teeth, comparing it to the commercially available chlorhexidine digluconate. The study was a triple blind study and the sample consisted of 32 patients, separated into 4 groups, who received different substances for mouthwash (choroxidine nano, vehicle, chlorhexidine commercially obtained and placebo). Oral examination, collection of oral epithelial cells and application of quantitative-qualitative questionnaires were carried out before and after the use of mouthwashes. The micronucleus test was performed to observe the frequency of micronuclei and possible genotoxicity after the use of the substances used in this study. It was observed that the nanoencapsulated chlorhexidine reduced gingival bleeding, also allowed a reduction in the presence of periodontal pockets and did not alter the dental staining, however it favored the accumulation of dental calculus and was the substance that presented the most unpleasant taste to the study participants. Regarding the micronuclei frequency, there was no alteration, demonstrating that this substance does not present genotoxic effects

Nanotechnology is a tool that can be applied to basically all sectors of science, and in the health area the high investment in this field has promoted the idea that nanotechnology products provide real advantages in the fight against various diseases. Advances in the knowledge on obtainment and stability of the disperse systems allow the development of differentiated vehicles such as, for example, nanoemulsions, which besides the inherent stability, serve as vehicles for several products, aiming to improve the pharmacokinetics. The Aeollanthus suaveolens speciesisrichinessentialoilsthatarewidelyusedinfolkmedicineforitsantimicrobial, anti-inflammatory, and analgesic activity. In the present work, a nanoemulsion was developed from the essential oil of the Aeollanthus suaveolens species, and an evaluation of its antimicrobial activity against the bacteria was made, comparing its efficiency with the essential oil of the plant. The process of obtaining the essential oil was accomplished through hydrodistillation in Clevenger-type apparatus, and the identification of the substances present in the essential oil was made via gas chromatography coupled to mass spectrometer (GC/MS). The nanoemulsions were prepared through a low energy input method. The microbiological activity was performed through the minimum inhibitory concentration (MIC) method with Gram- positive and Gram-negative strains. In the chromatographic analyzes, the major constituentsfoundintheessentialoilofA.suaveolenswereLinalool(40%)and(Z)-β- Farnesene (32.4%). The nanoemulsions showed reduced average size of particle (142.2 ± 0.832 nm) and low polydispersity index (0,165 ± 0,003), as well as signs of physical-chemical stability. The nanoemulsion had an inhibitory effect on S. aureus (0,52 mg/ml), P. mirabilis (0,52 mg/ml), P. aeruginosa (0,52 mg/ml), and E. faecalis (0,52 mg/ml) species; in comparison with the pure essential oil, the nanoemulsion antimicrobial efficacy of 100% was obtained. This formulation increased the efficiency of the oil in the bacterial strains employed. This study opens a perspective for the sustainable use of the vegetal species through low energy input technique, which can be reproduced as herbalmedicine.

Snakebite accidents represent a neglected public health problem in several regions, especially in South American countries such as Brazil, which presents the northern states as the main responsible for the high number of records in the country. The present study presents the clinical-epidemiological profile of ophidian accidents treated at the Emergency Hospital of Macapá (HE) and those registered in the Amapá Public Health Information System (SINAN-AP), which verified a similarity in the number of accidents occurring between municipalities amapaenses and Amapá and other States of the North Region of the country. This is a retrospective epidemiological investigation, by means of a documentary survey and consultation of the SINAN database, referring to the accidents recorded in the period from 2014 to 2017, and simple descriptive statistical analysis and cluster analysis for verification of representativity of the similarity matrix. There was an unreal decrease in the number of ophidian accident records attended at the Macapá Emergency Hospital and in the state of Amapá in the delimited period. The clinical-epidemiological profile of the accidents recorded in HH was characterized by the higher incidence of brown-skinned people, with elementary education, in farmers, who occurred in the first semester during the day in the capital of the state of Amazonas, in men, aged equal to or greater to 20 years, the lower limbs being more affected, presenting edema and pain as a more frequent sign and symptom, necrosis as the most incident complication; caused mainly by the snake of the genus Bothrops and with the time between the sting until the attendance greater than 3 hours until 6 hours. The profile found in the SINAN-AP accidents was differentiated in the educational variables, with a higher incidence in people without schooling; municipality of occurrence, with the innermost municipalities being more incidental and in the time of care, greater than 1 hours up to 3 hours. As for the number of accidents, it was observed a greater similarity between the municipalities of the interior of the state, compared with the capital, and between the states of Amapá and Roraima. A considerable amount of information was ignored in filling out the notification form and could generate unreliable statistical data to be used in the adoption of public policies to prevent and offer adequate hospital support.

This project aimed to perform a sociodemographic evaluation, to evaluate and compare the degree of satisfaction and quality of life of the population of all levels of the total population in relation to the total population and in the total prosthesis implanted in the city of Macapá, state of Amapá, Brazil . We interviewed 249 users of total prosthesis mucusuportada and 48 users of total prosthesis implanted through three questionnaires, OHIP-14Br, a visual analogue scale (VAS) and a sociodemographic questionnaire. The study variables were characterized by a detailed descriptive analysis. Descriptive measures were used as mean and standard deviation for a characterization of quantitative and absolute absolute variables and statistics for a qualitative and quantitative variables characterization. Fifty-five percent of the men standing and women participating in the research, while 56% of the men of women were victims of violence, 69% of those who committed prostitution were self-declared white, with 44% of them teaching with a family average of 7 to 10 minimum wages, 65%. Patients were given mucosuporta, 69% became familiar with 1 to 2 minors, 69%. "Time of use, prosthesis users implanted the mean age of 3.83 years for the superior prosthesis and 4.02 years for an average of 4, 4 years for the superior prosthesis and 4.45 years for the inferior one. When receiving an evaluation of the type of prosthesis, users of implant-supported prostheses were 100% very satisfied with the prostheses superior and inferior regarding the satisfaction of users of prosthesis mucusuportada, 90% of the users reported being satisfied with a superior prosthesis, however, 56% the quality of life was measured with 100% of users of implanted prosthesis, while users of prosthesis mucosuported, 73% liked to have a good quality, 22% obtained a classification of poor quality and 5% had a QOL as a good

EM PROCESSO DE SIGILO

The species Licania macrophylla Bent. popularly known as "anauerá" widely found in the Amazon, riverside communities use different parts of the plant for the treatment of amoebic parasitoses, dysenteric disorders, healing and anti-inflammatory action. The present study aims to investigate the gastroprotective activity of the ethanolic extract of the bark of the stem of Licania macrophylla in experimental animals. To investigate the activity proposed in the study was based on experimental models that mimic the etiological factors of gastric lesions in humans, such as acidified ethanol (local) and non-steroidal anti-inflammatory drugs (local and systemic). To perform the experiments, groups of animals with (n = 5) were used for each of the extract doses (100, 250 and 625 mg / kg), as well as for the negative control group (vehicle) and for the positive control group ( carbenoxolone). After each experiment, the stomachs were evaluated for the following parameters: (a) total area of the lesion, (b) percentage of ulcer, (c) index of ulcerative lesions; (d) inhibition or cure percentage. The EELM presented a gastroprotective effect (mean ± SEM) against gastric lesions induced by absolute ethanol, significantly reducing the total lesion area, percentage of ulcers and ulcerative lesion index at doses (250 and 625 mg / kg). respectively (53.76% and 84.15%) when compared to the vehicle-only group. For the second experimental protocol performed with acidified ethanol, the results showed that the animals treated with EELM at doses of (250 and 625mg / kg) expressly decreased when analyzing the total lesion area, percentage of ulcers and the rate of ulcerative lesions obtaining as percentage of healing: 71.05% and 90.19%, respectively. In the model of gastric lesion induction by NSAIDs, EELM was able to significantly reduce for all doses tested (100, 250 and 625 mg / kg): total lesion area, percentage of ulcers and ulcerative lesion index, (84.45%, 75.00% and 72.26%) were calculated when compared to the group that received only the vehicle. Thus suggesting antiulcerogenic effect via cytoprotective mechanisms. In view of the obtained results we can conclude that L. macrophylla extracts present antiulcerogenic action possibly due to a cytoprotective effect. However, complementary studies will be necessary to elucidate the mechanisms involved in gastroprotective action.

Introduction: The study is intended to investigate depression, anxiety, and alcohol and other drug use among postgraduate students beyond the reasons of satisfaction and difficulties perceived. The interest in studying anxiety, depression in the context of postgraduate studies emerged from the observation of the intrinsic and extrinsic pressures that students suffer in this stage of academic life. Objective: To identify levels of anxiety, depression and stress, level of satisfaction, perceived difficulties and the profile of alcohol and other drugs use of undergraduate students of the Federal University of Amapá. Method: In this study, a descriptive type of qualitative and quantitative cut study was carried out. The study was conducted at the Federal University of Amapá in postgraduate courses with 139 students. For data collection, a socioeconomic and academic questionnaire was used along with the EADS-21 instruments to assess anxiety, depression and stress symptoms and the WHO-ASSIST to assess the risks of psychoactive substance use. The quantitative data analysis was done through descriptive and inferential statistics with the Statistical Package for the Social Sciences program, and the qualitative data were analyzed through the technique of Collective Subject Discourse. Results: the majority of the population was aged between 20 and 30 years old, female, of dun ethnicity, with a family income above 5 minimum wages, in the State of Amapá, and as a source of income as a public servant. Among the subgroups of EADS-21 the one that presented the highest mean score was the stress that is classified as mild degree, then the symptoms of depression classified as moderate, third are the anxiety symptoms. Regarding the profile of use of psychoactive substances, the substance with the highest average in ASSIST were alcoholic beverages, followed by tobacco. The students had a space to justify the reasons for which they were satisfied or dissatisfied with the program, which originated the six speeches, among which four showed negative opinions and two with positive opinions. The reasons that led the students to think about giving up the course are inherent in the project, extracurricular activities, relationship with the supervisor and pressure with deadlines. Final Considerations: Educational institutions need to foster assistive and counseling policies that include postgraduate students, since this failure is perceived within the institutions, as well as working support groups to share experiences that lead to the approximation of students and teachers.

The search for innovative products that have biological activities and that come mainly from natural sources has gained more and more prominence in the scientific space. The plants have a wide distribution in nature and can be used in the production of larvicides, pupicides and repellents, where they can help in the prevention of some diseases that are transmitted by the Aedes aegypti mosquito. The objective of this work was to obtain the crude ethanolic extract (BSE) from the aerial parts of Siparuna guianensis, as well as to evaluate the larvicidal, pupicidal, repellent activity and to estimate the sub lethal effect of the concentrations (LC50 and LC90) of the plant product on the larvae. and pupae of Ae. aegypti. The dried and pulverized material was subjected to exhaustive extraction with 92% EtOH at room temperature. S. guianensis BSE was concentrated by rotary evaporator. The bioassays to evaluate larvicide, pupicide and repellency activities were performed against Aedes based on the procedures recommended by the World Health Organization (WHO, 2009). S. guianensis BSE was treated at different concentrations as a function of exposure time. The estimation of subletal, larvicidal and pupicidal effect of the plant extract was performed using (LC50 and CL90), the results for p <0.05; p <0.01 and p <0.001 according to Tukey's post-test ANOVA test, showed significant values, because the extract showed great efficiency in larval control with LC50 = 10.5 ppm and LC90 = 61.2 ppm, and an R = 0,9276 demonstrating good product linearity against Larvae. For concentrations of 100 and 200 ppm after 48h, an average variation of 60% to 78% of mortality was observed, while at 500 and 1000 ppm an average of 60% to 100% of deaths within 48 hours. In the pupicidal action the toxic effect was verified in all the concentrations with significant values of LC50 = 23.80 ppm and CL90 = 78.58 ppm, and an R=0.9339, which demonstrated an excellent pupicidal effectiveness of the tested product. With an average of 40% to 100% pupae death within a range of 2 to 24 h at concentrations of 50, 100, 250, 500 and 1000 ppm. In the repellency test at concentrations of 250, 500 and 1000 ppm, in general, as the concentration increased there was a decrease in the number of bites as a function of exposure time when compared to the negative control. S. guianensis extract thus demonstrated a potentiality in the control of the different life cycle stages of this vector. As well as a natural protection against the Ae. aegypti. Keywords: Siparuna guianensis. Vegetable extract. Larvicidal activity, pupicide and repellency. 

Key words: Siparuna guianensis. plant extract and alkaloids. larvicidal activity and repellency.

O Objective Structural clinical Examination (OSCE- Exame Clínico Objetivo
Estruturado) é uma metodologia de avaliação de competências clínicas, que vem
sendo utilizada mundialmente desde 1970 após ter sido descrita por Harden
enquanto no Brasil o seu uso é mais recente. Porém, estudos avaliando a sua
eficácia e aceitabilidade entre os estudantes ainda são escassos. Esta pesquisa teve
por escopo colaborar na produção de dados que possam fundamentar a eficiência
do modelo em pauta por meio da descrição e análise de aspectos qualitativos e
quantitativos. Para alcançar tais resultados, traçou-se como objetivo geral, investigar
a percepção do discente da enfermagem sobre o OSCE no 9o semestre na formação
acadêmica e da visão dos docentes através de um grupo focal. Com uma
abordagem quantitativa e qualitativa, a avaliação descreve estatisticamente,
utilizando SPSS versão 21.0, sendo que no grupo focal os dados e as análises
foram através do método preconizado por Bardin, bipolarizando as subcategorias em
aspectos positivos e negativos e às vezes neutros, havendo seis temas mais
prevalentes para a possibilidade de implantação do sistema de avaliação.Fora
empregado um questionário semi-estruturado, utilizando a escala Linkert,
respondidas por 24 estudantes. As respostas foram categorizadas e freqüênciada,
de tal forma que se chegou aos principais resultados: Com discordo fortemente em
média de 2,69%, discordo 10.36%, incerto 10.41%, concordo 46,43% e ao final
concordo fortemente 33,75%. Conclui-se parcialmente, que o OSCE poderá ser
utilizado como prática de avaliação, e poderá contribuir na formação acadêmica e
aprendizado, dos alunos da graduação de enfermagem, havendo, portanto
possibilidade de ocorrer mudanças no sistema de avaliação.

Introduction: Overweight and obesity have been a worldwide problem, caused by genetic factors, eating habits and absence of physical activity, which influences physical, psychological and social changes, increasing the level of prevalence of obesity in children and adolescentes. Objective: To determine the prevalence of overweight and obesity in adolescents 15 to 19 years old, of both sexes, who study in public schools in the city of Macapá/AP and, to identify the associated factors. Method: This is a cross-sectional study with an epidemiological outline with n = 409 students, n = 201 (49.15%) males and n = 208 (50.85%) females. The prevalence of overweight/obesity (dependent variable) was based on percent values of Body Mass Index, according to gender and age. The classification used was the World Health Organization's proposal, which establishes the following indicators: weight (<18.5), eutrophy (18,5 to 24,9), overweight (25 to 29,9) and obesity (30 to 34,9). Information on the associated factors (independent variables) was obtained through a questionnaire with socio-demographic and socioeconomic indicators, eating habits and behavioral variables. In the statistical analysis, prevalence and probability were used as measures of association with overweight and obesity by means of Odds Ratio with 95% confidence interval and p<0.05. Results: The prevalence of overweight and obesity among school was 26%, being more pronounced in males with 27% and in adolescents aged 17-19 years. Factors associated with overweight and obesity among males were: the type of home building material (p<0.02); the time too in front of the screens on weekdays and at the end of the week (p<0.01); the level of physical activity (p<0.03) and inadequate eating habits (p <0.01). Among the female adolescents, the positive associations were: family income (<0.01), school site (p<0.04), too much time in front of the screens on weekdays and at weekends (p <0.01). Conclusions: The prevalence of obesity in adolescents of public schools in the city of Macapá/AP was high and was associated with the sex and ages studied. The factors that were most associated with the prevalence of overweight and obesity were: adolescents of both sexes who spend more time in front of the screens; males living in households with poorer conditions, physically inactive and consuming foods of low nutritional value. In females attending schools in the central region of the city and of a lower socioeconomic stratum. Therefore, it is believed in the creation and diffusion by the school and other public institutions of actions on the benefits of regular practice of physical activity and healthy eating in the perspective of immediate change in the behavior of adolescents.

Introduction: Malaria is a disease that remains within the parasitic diseases of greater impact in the populations of the world, due to the extensive geographic distribution of its etiological agent. It is infectious and systemic, non-contagious, with manifestations of acute character and of chronic evolution, with high prevalence and morbidity. Caused by a protozoan of the genus Plasmodium and transmitted to humans by the bite of the female mosquito of the genus Anopheles, it usually produces: fever, chills and sweating. Depending on the infecting plasmodium, malaria differs in severity, complications, prognosis and treatment. Pregnant women are vulnerable to endemics because their immune status changes during pregnancy, making them more susceptible to changes in the course of pregnancy, increasing the risk of complicated forms of the disease such as: severe anemia, maternal death, miscarriage, childbirth premature, low birth weight and restricted intrauterine growth. Objective: To describe the occurrence of preterm births in pregnant women with malaria, attended at the Mãe Luzia Women's Hospital. Method: This study used the descriptive epidemiological method of a series of cases, with retrospective data collection from the secondary source from the period of 2012 to 2016, obtained from the Medical and Statistical Archive Service of the Mãe Luzia Women's Hospital, in the city of Macapá. Results: In the historical series, from 2012 to 2016, 95 deliveries of pregnant women with malaria were registered. The year 2013 was the year with the highest number of cases recorded in the historical series (25 cases) and 2006 the year with the lowest number (11 cases). Preterm births accounted for about 20% of all cases of pregnant women with malaria in the period under analysis, varying from 30% in 2012 to 9% in 2016. Throughout the analyzed period, the profile of women found was 22, 8 years, complete primary education and multiparous gestation. The Vivax species was present in 33% of the cases and the most adopted model was the vaginal route. Final considerations: It can be affirmed that there was a progressive decrease in the number of records of malaria cases in pregnant women, when compared with previous studies conducted in the last decade of the study, which can be explained as a consequence of the malaria control policy in pregnant women implemented in 2006 by the Ministry of Health in the states of the Legal Amazon.

Introduction: Malaria is an infectious, parasitic, systemic, non-contagious disease with episodic manifestations of acute and chronic evolution caused by a protozoan of the genus Plasmodium and transmitted to humans by the bite of the female mosquito of the genus Anopheles, producing fever, chills and sweating. In Brazil, the highest number of cases (99%) is verified in the legal Amazon, where children are highly vulnerable, as well as 914 million adolescents (10 to 19 years old) living in low-income countries have been relatively neglected. Therefore, the occurrence and spatial distribution of reported autochthonous cases of malaria in children and adolescents in the state of Amapá during the period from 2010 to 2015 was evaluated. Material and Methods: This is an epidemiological, ecological, descriptive study, based on secondary data obtained from the Malaria Epidemiological Surveillance System of the Health Surveillance Institute of the Ministry of Health and the Universal Database of the Unified Health System and the Brazilian Institute of Geography and Statistics, available online. Results and Discussions: 38,129 autochthonous malaria cases were analyzed between 2010 and 2015, an increase from 6,227 in 2010 to 8,366 in 2011, with an increase of (34.4%), after that year there was a 2015. From 2014 to 2015 increased (9.9%), from 4,877 to 5,361. The reduction in the analyzed period was (13.9%) in the absolute total of cases. The incidence occurred in both sexes (58.6%) in males and (41.4%) in females, with predominance among adolescents (28.6%) in the age group of 10-14 years and (30%) between 15-19 years. As for the distribution by main activity, stood out the agriculture, domestic activities and of garimpagem. As for seasonality, the second half of the year is the one that registered the highest occurrence in the months of October and November. In relation to the species, (84.91%) were caused by Plasmodium Vivax and (10.45%) Plasmodium Falciparum. More than half of the cases (60.7%) had two parasetemia crosses at the time of diagnosis and (79.59%) of the cases had no identification of the type of treatment performed. The municipalities of Alto Risco were: Serra do Navio (154.4), Oiapoque (116.0), Calçoene (109.5), Mazagão (in the case of malaria), according to the Annual Parasitic Incidence. (77.9), Porto Grande (75.4), Medium Risk: Tartarugalzinho (26.3), Ferreira Gomes (23.7), Santana (15.5), Laranjal (2), Jari (11,0) and Low Risk: Macapá (5,7), Cutias do Araguari (4,0), Pracuúba (3,2), Amapá (2,4), Vitória do Jari (1,4) and Itaubal (0.4). The localities with the highest records were the special areas of garimpo, indigenous area, settlements, rural areas as sites, villages and urban and peri-urban areas. Considerations: The data point to the importance of malaria in children and adolescents, suggesting the need to monitor this endemic disease in the State of Amapá, in order to reduce disease morbidity and improve rapid access to diagnosis and appropriate treatment. Involvement of basic care, epidemiological surveillance, and environmental monitoring should remain constant and health professionals need to be sensitized so that they immediately see the first clinical signs of the disease and are prepared to intervene in a timely manner.

Introduction: Overweight and obesity have been a worldwide problem, caused by genetic factors, eating habits and absence of physical activity, which influences physical, psychological and social changes, increasing the level of prevalence of obesity in children and adolescentes. Objective: To determine the prevalence of overweight and obesity in adolescents 15 to 19 years old, of both sexes, who study in public schools in the city of Macapá/AP and, to identify the associated factors. Method: This is a cross-sectional study with an epidemiological outline with n = 409 students, n = 201 (49.15%) males and n = 208 (50.85%) females. The prevalence of overweight/obesity (dependent variable) was based on percent values of Body Mass Index, according to gender and age. The classification used was the World Health Organization's proposal, which establishes the following indicators: weight (<18.5), eutrophy (18,5 to 24,9), overweight (25 to 29,9) and obesity (30 to 34,9). Information on the associated factors (independent variables) was obtained through a questionnaire with socio-demographic and socioeconomic indicators, eating habits and behavioral variables. In the statistical analysis, prevalence and probability were used as measures of association with overweight and obesity by means of Odds Ratio with 95% confidence interval and p<0.05. Results: The prevalence of overweight and obesity among school was 26%, being more pronounced in males with 27% and in adolescents aged 17-19 years. Factors associated with overweight and obesity among males were: the type of home building material (p<0.02); the time too in front of the screens on weekdays and at the end of the week (p<0.01); the level of physical activity (p<0.03) and inadequate eating habits (p <0.01). Among the female adolescents, the positive associations were: family income (<0.01), school site (p<0.04), too much time in front of the screens on weekdays and at weekends (p <0.01). Conclusions: The prevalence of obesity in adolescents of public schools in the city of Macapá/AP was high and was associated with the sex and ages studied. The factors that were most associated with the prevalence of overweight and obesity were: adolescents of both sexes who spend more time in front of the screens; males living in households with poorer conditions, physically inactive and consuming foods of low nutritional value. In females attending schools in the central region of the city and of a lower socioeconomic stratum. Therefore, it is believed in the creation and diffusion by the school and other public institutions of actions on the benefits of regular practice of physical activity and healthy eating in the perspective of immediate change in the behavior of adolescents.

Solid waste is the material that has been discarded after its useful life, which in itself is of no economic value and can be used or processed with adequate recycling. Waste generated as a result of health care activity also causes a significant social concern, which has been increasing, more significantly, since the 1980s. Such wastes are those that, due to their characteristics, composition and origin, require a to prevent the spread of infections. The management of hospital waste is governed by the basic principles of biosafety, integral management, minimization in generation, culture of non-production of garbage, precaution and prevention. The system of integral management for the management of hospital waste as the coordinated set of people, equipment, materials, supplies, specific regulations, plan, programs, activities and economic resources, which allow the proper management of waste by generators and providers of the garbage collection service. The objective of this research was to evaluate the management of the health services waste of the Basic Health Units at the Municipality of Macapá, knowing the dynamics of the management of Solid Health Wastes from each Basic Health Unit researched; in addition to identifying the level of knowledge and training received by the servers on the management of the RSS, verifying the perception of the residents of the UBS surrounding the RSS and evaluating the possible environmental and human health impacts generated by the UBS RSS. Research was done in 11 UBS located in the municipal headquarters of the city of Macapá and with the surrounding population, has a descriptive nature and quali-quantitative character. The questionnaire was adopted, with open and closed questions, and direct observation, as instruments of data collection. It was verified that only seven of them have RSS Management Plan. UBS have no control over the amount of waste generated. In all BHUs, continuous segregation of infectious, common and sharps-borne wastes is performed with internal storage as prescribed by relevant legislation. RSS managers have varied backgrounds. In the evaluation of the possible environmental impacts and human health generated by the UBS RSS, UBS did not produce radioactive type RSS, and only the infectious and piercing effects are segregated in the UBS. The negative points raised were: in only one UBS there is an external warehouse to store the containers of the time action, which are in poor condition; incorrectly stored residues were found in the internal collectors in most UBS; only one UBS respects the biosafety standards in the transportation of the conditioned waste to the waste room. The main positive points observed were: easy identification and visualization of the internal collection containers; the presence of sharps boxes (DESCARPACKS); the presence of carts consisting of washable material, rounded corners and fitted with lids in the internal transport of the RSS and in compliance with the biosafety standards in the operation of cleaning of the internal shelter of residues of the UBS. Taking into account the results obtained, it is suggested the seven UBS with deficiencies in waste management: Novo Horizonte, Marcelo Cândia, Hilda Iléia S. Ramos, São Pedro, Marabaixo, Rubim Aronovitch and Perpétuo Socorro, to establish an integrated management system for SSRs, with emphasis on staff training and establishment of adequate procedures for the entire process of managing these resources, from segregation, packaging, collection, storage, transportation, recycling, treatment and final disposal.
Keywords: Analyze. Management. Health. RSS.

A hysterectomy is the surgical act in which the uterus is removed. It is one of the most frequent gynecological surgeries performed in adult women in developed countries. Thus the objective of this research was to identify the quality of life of women who underwent hysterectomy. A descriptive exploratory study was carried out, with a cross - sectional design and a quantitative approach. The population consisted of 25 women. The data were collected through interviews and application of the questionnaires to patients who underwent hysterectomy at the Mãe Luzia Women's Hospital, from 2006 to 2016, using as collection instruments a form for the socioeconomic and clinical profile and the WHOQOL-BREF questionnaires and the Sexual Quotient - Female Version. Statistical analyzes of the data were performed in the Statistical Package for Social Sciences, version 20.0 for Windows. All the results obtained by the collection instruments were transcribed to the SPSS worksheet. The sample included 25 hysterectomized women aged 24 to 60 years - the mean age of the sample was 45.5 years (SD = 9.6 years). White women predominate (60.0%) and those who live with partners and children (48.0%). As for schooling, those with a high school education (36.0%) predominate. Most women consider that their quality of life is good (40.0%). About one quarter (24.0%) of the women had surgery 1 year ago. The results allow to conclude that 3 (12.0%) women use hormone, 8 (32.0%) are hypertensive, 3 (12.0%) are diabetic and 6 (24.0%) are alcoholics. As for the causes that led to hysterectomy, about 3 in 4 (76.0%) had uterine fibroids. It was observed that the quality of life in these women was affected in some domains and the sexual performance as well. Taking into account that even after the surgical procedure his quality of life was partially affected.

Keywords: Hysterectomy. Quality of life. Female Sexuality

The sexual practice is performed in multiple forms, among them are oral sex, often used in sexual relations. This practice is considered less risky in relation to the transmission of diseases when compared to other forms of sex, but can lead to sexually transmitted infections (STIs), such as Human Immunodeficiency Virus (HIV) and syphilis, especially in the presence of oral cavity, genitalia and / or anus. Among prostitutes, IST is an occupational hazard, since oral sexual practice is one of the activities inherent in the trade. In order to know the odontological and sociodemographic profile of individuals who practice prostitution in the city of Macapá / AP, the Research Project "Smiles of the Night" is characterized as an interdisciplinary action research that besides promoting the continued odontological treatment of professionals from the city of Macapá - Amapá, also aims to study several aspects related to these professionals. The present study was to make a quantitative descriptive cut of the results of sociodemographic data and the initial clinical dental evaluation of those professionals attended by the mentioned project. The study included 45 sex workers, over 18 years of age, of both sexes and using oral sex as a work tool. As instruments of data collection and recording, dental records, quantitative qualitative questionnaire and periodontal record sheets were used. Age, Income and Schooling variables were evaluated in relation to the odontological index of Sloman and gingival indices of bleeding (GBI) and oral hygiene simplified (OHSI), as well as the community periodontal index (CPI). As a result, 78% of the participants were female and 22% were male, 66.6% were under 30 years of age and 62% had individual income below a minimum wage. The Community Sloman index was a score of 9 with a need for high odontological intervention, considering the index of decayed and exodontic elements indicated to comprise 59.5% of the affected individuals. As to the periodontal indices, 66% of the dental surfaces surveyed had bacterial plaque and 49% of the sextants had bleeding, dental calculus or periodontal pocket, pointing to a high risk of infectivity. In the correlation between the sociodemographic variables and the Sloman index, Age correlated positively with Caries and Obturated teeth and the variable Income had positive correlation with Lost teeth. Regarding the GBI in relation to age and income, the correlation was positive, already related to schooling, and it was inversely proportional. The OHSI, presented negative correlation and inversely proportional between Schooling and Excluded tooth. No significant correlation was found with sociodemographic variables and CPI. The sociodemographic indexes showed that the respondents showed a predominantly young, heterosexual profile, with a monthly income below a minimum wage and a schooling level of elementary school to a full average and that they do not have other sources of income if not prostitution. Regarding odontological findings, there was a significant deficit regarding oral hygiene care and a significant presence of gingival bleeding; dental need considered to be very high and absence of clinically detectable evidence of sexually transmitted infections in the oral cavity. Dental intercurrences are possibly related to socio-educational factors rather than financial factors, which demonstrates the need to implement preventive work on the reinforcement of correct hygiene habits, as well as collective health strategies aimed at preventive and preventive work. hygiene dressings of sex workers

Introduction: the visual system is responsible for the integration of several functions, so blindness when not adequately lived may favor the development of depressive symptomatology. Objective: to evaluate the symptoms of depression in blindness and its determinants. Methodology: the date gathering was made using: semi-structured interview, to know the sociodemographic profile of the sample and the conditions of the disability; the Beck Depression Inventory, to evaluate the symptoms of depression and a visual acuity test, to verify the perception of light. The study was carried out in the region of Legal Amazon, in the municipality of Macapá-Amapá. To evaluate the occurrence of symptoms of depression in blindness and to identify the existence of a relationship between the categorical variables, the Mann-Whitney statistical test was applied and, to correlate the numerical variables, the Spearman Correlation test was used, and the significance value p <0.05. Results: the sample consisted of 68 blind people, with a predominance of males (60.3%), in the age group above 50 years (33.8%), unmarried individuals (57.3%) with higher education (44.1%) and family income between 1-3 minimum salaries (36.7%). The highest index was blind between 10-20 years (26.5%), with blindness time between 01 month-10 years (29.4%), with no light perception in both eyes (53%), with good capacity of locomotion (42.6%) and displacement with the aid of a guide (75%). The presence of symptoms of depression was observed in 39.7% of the sample, with level of statistical significance p = 0.001. After stratification, using the Beck Depression Inventory, the determinants for depressive symptomatology were: female; advanced age; lower schooling; better family income; greater age of blindness; shorter duration of blindness; absence of light in both eyes and displacement performed with the aid of a guide. Conclusions: the results indicated that there is a significant association between blindness and symptoms of depression and that some determinants for this symptomatology can not be controlled, therefore, it is recommended that health professionals work in the promotion of mental health, aiming to improve the quality of life and social inclusion of this population.
Keywords: Visual Impairment. Blindness. Depression.

From the earliest days medicinal plants are used for a wide range of purposes in folk medicine, ranging from the treatment of a variety of diseases to use as repellents and insecticides, such as eucalyptus and citronella. These compounds may act against vectors such as Aedes aegypti, which are capable of transmitting arboviruses such as: Dengue, Zika, Chikungunya, and Yellow Fever, which in the current scenario are characterized as a serious public health problem. The objective of this work is to obtain and characterize the essential oil of Siparuna guianensis and to evaluate its larvicidal and repellent activity against Aedes aegypti. The aerial parts of the S. guianensis plant were used to extract the essential oil. The plant material was obtained in the municipality of Macapá, Amapá. The essential oil was extracted by hydrodistillation and the identifications of the bioactive constituents were performed by gas chromatography and mass spectroscopy (GC-MS). Through the GC-MS, 78 compounds were identified in the essential oil, among them Terpinolene (68.27%) and α-Muurolol (10.61%) are the majority. The yield of essential oil was 0.83%. The results of the larvicidal bioassays indicated mortality rates of 68.66%, 76.66%, 77.33%, 78.66%, 85.33% at concentrations of 40, 80, 120, 160 and 200 mg/L, respectively, during 48 hours. For the repellency bioassays an average of 5.00, 4.00, 4.33, 4.33, 4.00, 3.66 and 2.33 landings was obtained in the respective times of 30, 60, 90, 120, 150 and 180 minutes for the concentration of 1000 mg/L. According to the results, the essential oil of S. guianensis presents larvicidal action and a strong repellent action for the highest concentration studied

A utilização das plantas medicinais para tratamento, cura e prevenção de doenças é descrito desde os tempos mais remotos. Das espécies em destaque a Parahancornia amapa (Huber) Ducke (Apocynaceae), é uma planta encontrada no Estado do Amapá amplamente usada como fonte medicinal pela população para o tratamento de diversas patologias. O presente estudo tem como objetivo avaliar a genotoxidade/antigenotoxidade do extrato metanólico das cascas do caule de P.amapa. Após identificação botânica as cascas foram secas em estufa de ar circulante até sua completa desidratação, após secagem as mesmas foram trituradas e submetidas ao processo de maceração numa proporção de 1:5. Para obtenção do extrato, a solução obtida após maceração foi colocada em um evaporador roratório para eliminação do solvente utilizado, por fim com o extrato metanólico finalizado foi realizado o Teste de Micronúcleo que se baseia na análise da frequência de danos ocorridos ao DNA. Os animais (camundongos swiss, machos/6 por grupo) foram tratados por 15 dias com as seguintes concentrações: 250, 500, 1000 e 2000 mg/kg p.c, além dos grupos controle positivo (doxorrubicina, DXR, 16 mg/kg p.c), negativo e veículo (DMSO). As concentrações da P. amapa foram administradas nos animais via gavage, bem como o controle negativo e veículo, já o controle positivo foi administrado intraperitonealmente. As coletas de sangue periférico foram realizadas 24h, 48h, 7 e 15 dias para ensaio genotóxico. Para a avaliação antigenotóxica além das concentrações utilizadas da P. amapa, no 14º dia os camundongos foram tratados intraperitoneamentel com DXR (16 mg / kg p. c) e a coleta foi realizado 24h e 48h. Uma única dosagem via intraperitoneal de DXR (controle positivo) mostrou um resultado eficaz sendo a média de 24,8 para o tratamento genotóxico (48horas) e de 15,33 e 17,17 para os tratamentos antigenotóxicos 24 e 48 horas respectivamente. Ao ter associado a DXR com as concentrações de P. amapa no décimo quarto dia (14º), pôde ser observada uma redução entre 43,76% a 50,68% para o tratamento de 24 horas e em 48 horas foi de 51,50% a 63,62% quando comparado ao grupo de animais tratados com a DRX. As concentrações administradas do extrato de P. amapa não apresentaram aumento proporcional na redução da atividade genotoxica no período de 24h e 48h, inferindo desta forma ausência em relação à dose resposta. Assim foi observado que o extrato metanólico da Parahancornia amapa não demonstrou efeito genotóxico além de demonstrar ação protetora da P. amapa frente aos danos no DNA induzidos pela DXR.

Amasonia campestris (Aubl.) Moldenke, pertencente à família Lamiaceae, encontrada nas regiões Norte, Nordeste, Centro-Oeste e Sudeste do Brasil. É subarbustiva, apresenta ramos castanhos a vináceos, com folhas geralmente agrupadas na região mediana, com ápices agudas e margens serradas, possui flores tubulares pequenas e amarelas acompanhadas de brácteas florais avermelhadas. O chá da Amasonia campestris é utilizado para o tratamento do diabetes pela população. Em face dessa atividade biológica o presente estudo avaliou o potencial genotóxico e antigenotóxico da Amasonia campestris em eritrócitos policromáticos de camundongos Swiss. Os animais foram tratados com as seguintes concentrações da Amasonia campestris: 250, 500, 1000 e 2000 mg/kg p.c, foram incluídos grupos de controle positivo (doxorrubicina, DXR, 15 mg/kg p.c) e negativo (água). As concentrações da Amasonia campestris foram administradas nos animais via gavage, bem como o controle negativo, já o controle positivo foi administrado intraperitonealmente. Os animais foram tratados de acordo com os pesos durante 15 dias. Foram coletadas amostras de sangue periférico caudal nos seguintes dias: 24 e 48h após a primeira gavage, 7 dias e 15 dias. Para a avaliação antigenotóxica no 14o dia os camundongos foram tratados com injeções intraperitoneal de DXR (16 mg / kg p. c). Após os testes, foi feito a contagem de 2.000 eritrócitos policromáticos por animal, de cada grupo proposto, para avaliação da frequência de Micronúcleos.

Pentaclethra macroloba, commonly known as "Pracaxi", is a medicinal plant abundant in the Amazon region, has current use in folk medicine in the communities of this region, as antiinflammatory, healing and for treatment of gastric problems. The present study aims to investigate the gastroprotective activity of the metanolic extract of the stem bark of Pentaclethra macroloba (Willd.) Kuntze, as well as to identify possible mechanisms involved in this activity in experimental animals. For this, the methanolic extract of Pentaclethra macroloba (EMPM) was obtained by cold maceration, and concentrated by rotaevaporation. Evidence of EMPM activity was based on experimental models that mimic the etiological factors of gastric lesions in humans, such as acidified ethanol (local) and non-steroidal antiinflammatory drugs (local and systemic). In these experiments a group of animals (n = 5) were used for each of the three dose levels of the extract (100, 250 and 625 mg / kg), as well as for the control group (vehicle). After each experiment, the stomachs were evaluated for the following parameters: (a) total area of the lesion, (b) percentage of ulcer, (c) index of ulcerative lesions; (d) inhibition or cure percentage. EMPM showed a gastroprotective effect (mean ± SEM) against gastric lesions induced by acidified ethanol, decreasing at all doses (100, 250 and 625 mg / kg): total lesion area, percentage of ulcers and ulcerative lesion index , reaching a cure rate of: 96.08%; 98.51% and 100% when compared to the vehicle-only group. This demonstrates an expressive gastroprotective activity against local aggressors. In the model of induction of gastric lesion by NSAIDs, EMPM, in the dose of 625 mg / kg, was able to reduce all parameters evaluated, demonstrating a Cure percentage of up to 84.33%. Suggesting antiulcerogenic effect via cytoprotective mechanisms. To investigate the mechanisms involved in the gastroprotective action of EMPM, the cicatrizing and antisecretory action of EMPM in pyloric ligature-induced ulcer models was assessed using two administration routes. The EMPM (625 mg / kg) promoted greater protection of the gastric mucosa when administered by intraduodenal route with about 63.7% cure, compared to the oral administration where this percentage was only 21% cure. These results suggest that the action of the extract occurs mainly due to a systemic effect. The parameters of gastric content volume, pH, and free acidity were not altered in any of the protocols developed. The involvement of important gastric mucosal protective agents such as sulfhydryl groups and nitric oxide was also evaluated in this response. It was observed, therefore, that when the extract was administered in the presence of inhibitors (NEM and L-NANE), respectively, of sulfhydryl groups of nitric oxide, attenuation of the antiulcerogenic response occurred for both parameters evaluated, demonstrating that they participate in the gastroprotective mechanism evoked by the extract. In view of all the results obtained, we concluded that the extract of Pentaclethra macroloba presents a remarkable antiulcerogenic activity, possibly due to a predominantly systemic effect related to the participation of sulfhydryl groups and nitric oxide, and without apparent involvement of gastric antisecretory activity. Keywords: Antiulcerogenic Mechanism; Medicinal Plant; Pracaxi.

Diabetes mellitus (DM) is one of the chronic noncommunicable diseases that is increasingly reaching population in general and in large proportions, being considered as a public health problem. The time of evolution of this disease tends to deteriorate health state and this provokes arising complications caused by a inadequate glycemic control, possibly leading to a decrease in the quality of life of the person with DM. This study has as a objective evaluate the QV of people with DM in follow-up in the Family Health Strategy (ESF) teams in the city of Macapá-AP. a descriptive exploratory study with transversal delineating and a quantitative approach was carried out with 308 people with DM in attendance in 68 ESF teams, a sample composed by a random sample stratified with proportional sharing, and included people aged 18 years or over, of both genders, all with type 2 DM. The data were collected using two instruments, one composed of sociodemographic and clinical variables and the other for evaluation of QV, the Diabetes Assessment Tool 39 (D-39). Predominance of female individuals, aged 60 to 69 years (n=95;31%), average of 60.6 years, married (n=148;48%), retired (n=106;34%), with income of 1 to 3 minimum wages (n=221;72%) and with incomplete elementar school (n=123;40%). The most don’t practice physical exercise (n=225;73%), but deny alcoholism and/or smoking (n=195;63%). The prevalent comorbidity was hypertension (n=172;56%), with a DM diagnosis time of more than 10 years (n=119;39%), presenting inadequate glycemic control (n=198;64%), with a mean glucose level of 218 mg / dl. At the evaluation of QV, the domain anxiety and worry was the most affected (40.2±11), being the domains social overload (10.7±9.8) and sexual functioning (19±16) with the lowest scores. Women had a higher QV than men with average24±23 e 23±18 respectively. The youngest patients had the most affected QV in the DM control domains -0.2 (0.002), anxiety and worry 0.1 (0.009), social overload -0.1 (0.0001), sexual functioning -0.2 (0.0001) and total score -0.1 (0.02). And those with random glycemia outside the therapeutic target 0.1 (<0.05), the sexual functioning 0.2 (0.04) and severity of DM 0.1 (<0.05) , were most affected. Therefore, knowing the profile and assessing the QV of people with DM is paramount for the planning of health promotion actions carried out by a multiprofessional team aimed at this public, mainly in the field of primary health care.
KEY WORDS: Diabetes Mellitus; Quality of life; Primary Health Care.

Photodynamic therapy (PDT) is a technique that consists in the production of reactive oxygen species capable of rendering cells and microorganisms unfeasible, from the combination of a photosensitizer, light and tissue oxygen, thus having application in the various health areas. The objective of the present work was to evaluate the effects of two photodynamic therapy techniques on reducing the bacterial load of alveoli after extraction. The first technique associated the photosensitizer (FS) curcumin to the blue LED light source (CUR + LED) and the second associated the blue methylene FS to the low power Red Laser (AM + LASER). The study was performed in 20 patients who had indication of exodontia, being divided into two groups (n = 10). For the CUR + LED group, the exodontia was performed, followed by drip therapy of curcumin FS and photoactivation with LED (470nm). For the AM + LASER group after the exodontia was carried out the therapy with methylene blue drip followed by irradiation of the Red Laser (660nm). To evaluate the decontaminating effect of each technique, a microbiological analysis was performed before and after the therapy. The collections were made with the aid of paper cone that was inserted inside the alveolus. In the laboratory, the collected samples were diluted in buffered saline solution to be seeded in blood agar and kept in a bacteriological incubator at 37ºC for 24 hours, then counting the Colony Forming Units (CFU) with the help of a magnifying glass in a counter under light. The reduction between both groups was significant, being 69.00% for the CUR + LED group and 66.99% for the AM + LASER group (p <0.05). These results indicate that the two PDT techniques tested were shown to be effective methods for microbial reduction.

The dissertation presents studies about the prevalence of malocclusion and evaluation of the facial pattern in students of public schools in the city of Macapá - Amapá. In Brazil and especially in the North region, malocclusion and all basic oral health care deserve special attention. However, access to public dental services is extremely difficult, especially for the economically disadvantaged population. According to the latest survey, 64% of the population of Macapá does not have access to dental services on a regular basis, since we do not have a sector or program focused on this problem or the simpler preventive procedures, much less complex ones, accumulating the need for orthodontic treatment. Thus, the general objective of this study was to evaluate the prevalence of dental malocclusions and types of facial patterns in students (aged 11 to 17 years) of public schools in Macapá - Ap. In relation to methodological aspects, - the use of bibliographical research to construct the theoretical foundations; then the use of field research in universe was made up of the following public schools: Maria de Nazaré Pereira Vasconcelos State School, Amapá Municipal School and Marechal Castelo Branco State School. From where it extracted after participating in the biggest triage of the good group, sample of 300 selected students in the age group of 11 to 17 years and mainly without being doing dental treatment. In relation to the objectives, an epidemiological survey carried out and an observational study carried out. Inclusion criteria: for convenience according to the proposed age requirement (11 to 17 years) and had not undergone previous orthodontic treatment. The following instruments: clinical examination, Oral and facial photographic record, Frankfurt plane of the head parallel to the ground, and intra- and inter-examiner tests. The data obtained tabulated in Excel spreadsheet, and the prevalence of OM classes were determined by simple counting, as well as the distribution of facial pattern types. The data analyzed under the quantitative and exploratory approaches. The results showed that the facial pattern I was the most prevalent. The crowding and malocclusion were the most frequent occurrences in the sagittal plane, also in the sagittal plane, the Class I and II malocclusions were the most observed, in the vertical direction the open bite was more prevalent, despite the number of students that the developed to be low in relation to those who developed the other classifications. It concluded that in the results, a relationship between the absence of treatment and adequate dental monitoring with the incidence of dental malocclusions observed. It is recommended, then, some possibilities of dental intervention that can have satisfactory results if the State, Municipality, Dentist of the Good Project and adolescents participate in the whole process of screening in social and educational actions that, when carried out in public schools, can soften the problems of the absence of dental treatment and follow-up of adolescents.

Hypothyroidism is caused by dysfunctions in the thyroid gland, which is responsible for much of the metabolic regulation of our body; helps in the hormonal balance and the correct functioning of the organs. The malfunction of the gland causes a general deregulation in the body's metabolism, the Thyroiditis, the most common being those related to Hypothyroidism. This disorder is responsible for: fatigue, cold intolerance, deceleration of heart rate, joint pain, constipation, hair loss, brittle nails, drowsiness, weight gain, increased blood cholesterol, among other factors. Objective: We sought to identify the effects of Dynamic Training (walking / running) and Resistance Training (bodybuilding) in improving the metabolic, lipid and functional condition of women with hypothyroidism. Methodology: It was performed through the exploratory method, with a quantitative approach to obtain the data, with the aid of instruments such as: physical and functional evaluation and laboratory tests of metabolic and hormonal markers. The sample had a total of 31 female volunteers, between 25 and 60 years of age, with the hormonal rate stabilized with hormone repository, having a closed diagnosis of thyroiditis of the type Chronic hypothyroidism. By means of field research using three groups (Control, Dynamic Training and Resistance Training), we were able to identify the benefits caused by physical exercise directed by the Statistical Package for Social Sciences (SPSS) version 22 for Windows, with ANOVA test and having the normality evaluation done through the Shapiro-Wilk Test, the results of these tests (95%) Results: It was identified through the data collected, that at the end of 12 weeks of training, the Dynamic Training group caused a greater improvement of the Weight -4.4%, BMI -4.4%, Cholesterol -31.3%, HDL + 22%, no-HDL -44.7%, LDL -38%, and VO2max + 67.7%, and Dorsal Force + 48, 8%. The resistance training obtained the greatest improvement in the strength of the right +26,8% and left, 29.4%, linear flexibility +39,1%, and triglycerides -44 , 1%. Conclusion: It was identified that the two types of training have benefits having a greater improvement of weight loss, BMI, Cholesterol, HDL, Non-HDL, LDL and VO2max increase and Dorsal Strength for Dynamic Training and Resistance Training the improvement noted was in Flexibility, Strength upper limbs and decrease in Triglycerides. This corroborates the idea that any of the activities cause great benefit to the body of people with hypothyroidism.
Keywords: Hypothyroidism. Metabolism. Resistance Exercise. Dynamic Exercise.

The teaching process of the courses in the area of health needs to be in constant process of renewal and adaptation to the realities that these professionals will face when acting, In recent years, several education policies and initiatives of higher education institutions and social control in health have stimulated the adaptation and renewal of the teaching-learning process of health professionals. Thus, it is fundamental that the changes in this process aim, in the area of health, the best professional training in view of the multiple visions for direct action with the population. Facing this context is the medical course of the Federal University of Amapá - UNIFAP, which, through the Integration of Service and Community Integration course, aims at the formation of a qualified medical professional to work in the health-disease process, as well as community. In this sense, the need arises to produce the matrix of competences that the student is expected to have at the end of the course and to seek the adequacy of theory and practice. This study therefore aims to build a matrix of competencies for the Integrating Community Teaching Module of the UNIFAP medical course, in addition and make a preliminary assessment of how is the integration in said course, in the view of the student in their practice of interaction teaching services and community. It was also sought to identify the activities that are being carried out in the course in question, that is, as the students who are developing the skills in primary care. The study was descriptive with quantitative-qualitative approach of investigative nature, in which the matrix was elaborated and implemented. As main results, it was possible to indicate that the students were satisfied with the way the discipline was approached, having a positive impact on their training.
Keywords: Medical curriculum, community teaching, medicine, teaching, community.

ABSTRACT
Traffic and accidents has been a subject much researched in Brazil and abroad because of their harmful consequences to individuals and organizations. When referring to traffic accident and hospitalization, stress is associated at different levels and times, thus compromising the individual's physical and emotional health. In view of these issues, the present study aimed to know about the environmental factors that trigger stress in traffic accidents hospitalized at the Emergency Hospital Osvaldo Cruz (HE) of Macapá / AP. The objective was to evaluate the environmental comfort parameters of hospitalization regarding temperature, carbon dioxide (CO2) concentration and sound intensity as being one of the stress - triggering factors in hospitalized traffic accident victims. This is a descriptive, exploratory, cross-sectional study that used quantitative data from a sample of 72 patients. To obtain the data, a sociodemographic questionnaire, accident data, a semi-structured interview script, ISSL Adult Stress Symptom Inventory, Lipp. As for the evaluation of the hospital environment in which the injured person was exposed, the Thermo-hygro- CO2 meter (M 98132S) was used to measure the level of carbon gas (CO2) and temperature. To verify the sound intensity, the Dr. Meter-Sound Level Meter (MS10) was used. In inferential statistics, a multiple linear regression model and simple logistic regression were used to verify the influence of environmental variables on the level of stress in the patients. In all analyzes, the level of significance (α) was 5%, that is, p <0.05. There was a predominance of male victims (84.7%), aged between 18 and 29 years (67.4%), mostly motorcyclists (86%), civil status (43.1%) for stable union, schooling with full secondary education (33.3), income from a minimum wage (52.8%), Catholic religion (48.6%). Of the participants (75.0%) presented symptoms of stress, being (63.9%) with psychological predominance and (11.1%) physical. Regarding the stress phase, 27.9% (n = 20) were in the resistance phase, 20.8% (n = 15) in the near exhaustion phase, 19.4% (n = 14) in the alert phase, followed by 6.9% (n = 5) in the exhaustion phase and the remaining 25.0% (n = 18) had no stress. These results are consistent with other studies showing the need to implement preventive measures directed at young males, especially motorcyclists. As for comfort in both wards and corridors CO2 (above 1,000 ppm) in disagreement with current legislation, as well as temperature and sound intensity.
Key words: Traffic accidents. Hospital environment. Hospitalization. Stress.

The use of medicinal plants is a very common practice and widespread in many parts of the world, for medical purposes, treatment, cure and prevention of diseases. In addition, the plants are rich in metals that can be beneficial to health or not. The Fridericia chica (Bonpl.) L. G. Lohmann is a Bignoniaceae, with great occurrence in the Amazon region, being popularly known as "pariri", “cajuru”, “chica”, “cipó-pau” e “crejer”. The anti-anemic property of this species is reported on the popular medicine and described in the literature, but little attention has been given to the understanding of such property, as well as its mineral content. The iron deficiency anemia affects approximately two billion people in the whole planet, being in Brazil considered a public health problem of great magnitude. This study aimed to determine the concentration of the inorganic constituents (Fe, Zn, Mn, Mg, Pb, Cu, Ni, and Cr), with focus on the element iron, in soil, leaf, tea and tincture of F. chica, from the Institute of Scientific and Technological Research of the State of Amapá– IEPA and domestic environment, in the Fazendinha district, on the rainy and dry seasons of the amazon region. The analyzes of the samples were performed by flame atomic absorption spectrometry, after their pre-treatment. In the soil, mean iron concentration presented a significant statistical difference (p <0.05) between the sites, mainly from the IEPA environment, which presented a higher average value (266.29 mg kg-1) than the mean value (248.30 mg kg-1) of the District Fazendinha . On the rainy season, the iron was found in the higher concentration in the dried leaves of Fazendinha’s environment (25.88 µg g-1) when compared to IEPA´S environment (19.48 µg g-1). In the analyzed samples of tea (leaves in natura), the magnesium was the major mineral for both decoction (133.62 – 103.49 µg g-1) and infusion (102.80 – 91.30 µg g-1) in the two amazon stations, with significant statistical difference (p <0.05). The decoction of leaves, in general, was the most efficient method in the extraction of almost all the elements (except for iron and Zn). In tincture, magnesium was the mineral with the highest extraction (2.06 µg g-1 IEPA and 2.04 µg g-1 Fazendinha), in the rainy season. The iron metal had a more efficient extraction in the tea samples when compared to the tincture samples (1.62 µg g-1 IEPA and 1.46 µg g-1 Fazendinha), in the dry season, especially that obtained by infusion (5.65 µg g-1) of Fazendinha, presenting statistical significance (p <0.05). Therefore, this plant species presents a considerable content of iron in the aerial parts (leaves), being its greater concentration obtained from the aqueous extracts (teas) in relation to the hydroalcoholic ones (tinctures), in the dry season. The Magnesium was the major element in both infusion, decoction and tincture. In a set these results demonstrate that there is a need for improvement in the extraction process of Fe to prepare phytotherapic products, in addition, such extracts can be considered as probable sources of nutritional supplementation of mineral nutrients in the human diet, due to the function of these in many biochemical processes and physiological.

Keywords: Friderichia chica. Atomic absorption spectrometry. Inorganic constituents. Iron deficiency.

Introduction: Clinical laboratories are health facilities that provide resources for outpatient and/or emergency diagnoses, being normatizated in Brazil by the Collegiate Board of Directors Resolution (RDC) N. 302, October 13, 2005. Objective: The aim of this study was to apply a normative evaluation in clinical laboratories, based on RDCN. 302, October 13, 2005. Methods: Research of normative, basic, observational, reference and qualitative and quantitative self-assessment, exploratory, bibliographical, laboratory and cross-sectional. Twelve laboratories, including public and private, participated in the research. Results: The percentage of adherence to the normative follow-up required by the federal health agency was 65% for laboratory 1,78% for laboratories 2 and 9, 79% for laboratories 3, 6 and 12, 75% for laboratory 4 , 73% for laboratory 5, 73% for laboratory 7, 72% for laboratory 8, 69% for laboratory 10, and 77% for laboratory 11. Conclusion: Laboratories 2, 3, 4, 6, 9 , 11 and 12 were evaluated as satisfactory. Laboratories 1, 5, 7, 8 and 10 were evaluated as partially satisfactory. There were no laboratories that were evaluated as unsatisfactory.

A gestação compreende um estado natural de estresse fisiológico para o corpo, no
qual todos os sistemas corporais tornam-se alvos de modificações. O sistema
visual, como um desses sistemas, também sofre adaptações, podendo envolver
componentes ópticos e/ou neurais, afetando os processos morfológicos e
funcionais de forma transitória ou permanente. Embora a maioria das complicações
oculares durante a gestação seja leve, transitória e normalmente não necessita de
tratamento, algumas são ocasionalmente graves, permanentes e requerem
encaminhamentos oftalmológicos, podendo ser despercebidas pela gestante. Este
trabalho trouxe como objetivo investigar os aspectos morfofuncionais do sistema
visual de gestantes assistidas no pré-natal de risco habitual e comparar ao
desempenho visual de mulheres não grávidas. Este é um estudo epidemiológico,
analítico, do tipo transversal com abordagem quantitativa. Compreendeu três
etapas, a saber: a etapa 1 correspondeu à triagem das grávidas através da
anamnese, da determinação da acuidade visual e Ishihara; a etapa 2 englobou a
avaliação psicofísica para visão de cores com o teste de Farnsworth D15 e
Lanthony D15; e a etapa 3 finalizou o trabalho com a avaliação clínica oftalmológica
através da refratometria, pressão intraocular, retinografia e tomografia de coerência
óptica. Para a análise das etapas 1 e 2, foi feita a estatística descritiva destes
exames para o grupo das gestantes. Para avaliar a diferença na discriminação de
cores entre as gestantes e as mulheres não grávidas, foram usados os testes
Shapiro-Wilke o de Kruskal-Wallis. Para a tomografia, foram determinadas faixas
de normalidade para os seguintes parâmetros: espessura foveal, espessura média
das fibras do nervo óptico, espessura dos quadrantes temporal, nasal, superior e
inferior dos olhos direito e esquerdo. Os resultados mostram que não houve
diferença estatística em nenhum dos parâmetros analisados entre o grupo controle
e as gestantes nos três trimestres no teste de Farnsworth D15. As gestantes do
terceiro trimestre exibiram maiores valores de C-index e S-index do que o grupo
controle (C-index, p= 0,023; S-Index p = 0,027) e as gestantes do primeiro trimestre
(C-index, p= 0,015; S-Index p = 0,021) no teste Lanthony D15 dessaturado. A
tomografia de coerência óptica mostrou que pelo menos 40% das gestantes
apresentavam alterações morfológicas na retina e no nervo óptico. A análise
funcional mostrou que existe perda da visão de cores durante a gravidez,
culminando com a perda significativa em gestantes no terceiro trimestre quando
comparadas às do primeiro trimestre e mulheres não grávidas. Leves alterações
retinianas e no nervo óptico podem ser responsáveis por esta perda progressiva.

Medicinal plants are routinely used by traditional populations. Copaiba (Copaifera reticulata Ducke) oleoresin is often used to treat inflammations; however, it is not easily absorbed by the skin in its natural form. The nanoemulsion of copaiba oil, with its hydrophilic properties and nanometric particles, enhances β-Caryophyllene permeation through the transdermal barrier. The low viscosity of the nanoemulsion can be overcome by combining it with hydrogels (Carbopol®) to improve topical use to treat inflammation. The form of presentation of the active ingredient in the formulation determines skin permeation, with nanoemulsions being the most effective form. Low-frequency ultrasound, by means of phonophoresis, is an important resource that enhances skin permeability of therapeutic substances such as oils obtained from plants with anti-inflammatory properties and nanoemulsions. The objective of this study was to analyze the effect of the C. reticulata Ducke oleoresin in its natural form and of its nanoemulsion gel (nanogel), applied topically or combined with phonophoresis, on muscle repair in Wistar rats submitted to traumatic injury. A copaiba nanoemulsion was prepared with 5% copaiba oil, 5% Polysorbate 80, and 90% water. The nanoemulsion obtained in five replications was incorporated into the Carbopol® in concentrations of 20% nanoemulsion and 80% Carbopol®. The study adhered to all ethical principles regarding the experimental use of animals. Twenty-four animals (males, ± 300g, ± 60 days of life) were submitted to injury to the right gastrocnemius muscle by direct impact with a metal cylinder (267g). After this procedure, the animals were randomly divided into the following groups with 4 rats each: G1 (control), G2 (topical oleoresin), G3 (topical nanogel), G4 (ultrasound), G5 (oleoresin with phonophoresis) and G6 (nanogel with phonophoresis). The treated groups were submitted to five sessions. To analyze muscle repair, blood samples were collected for measurement of the plasma enzymes Aspartate Aminotransferase (AST) and Creatine Kinase (CK) on the 2nd and 6th days after muscle injury. Statistical analysis included Student's t test (intragroup) and ANOVA followed by Tukey’s post hoc test (intergroup), both with significance of p≤0.05. The results showed a significant reduction in AST in G2 (p=0.0314), G5 (p=0.0222), and G6 (p=0.0314) and in CK in G2 (p=0.0176) and G6 (p=0.0396). When compared to G1 on the 6th day after injury, G2, G5, and G6 presented greater AST reductions (p=0.0155). Therefore, the topical application of the oleoresin and of the nanogel, combined with phonophoresis, were efficient in repairing skeletal muscle.

Diabetes Mellitus (DM), a chronic disease that is described by several authors as a pandemic with increasing proportions. Considering the epidemiological context, attention to the person with DM has actions implemented throughout the emergence of the Unified Health System, mainly in the scope of Primary Care (AB). Stratify the care regarding the risk, is a proposal to organize a care directed to the needs of the person with chronic disease, specifically Diabetes Mellitus. This research has the objective of classifying the Risk Stratification for the care of people with Diabetes Mellitus of a Basic Health Unit. A cross-sectional, quantitative study with the participation of 75 people with DM attended at the Basic Health Unit of the Federal University of Amapá / UNIFAP, and data collection was performed using an instrument containing sociodemographic and clinical variables and Risk Stratification based on the proposal of Sturmer and Biachinni (in press, 2012) and Cavalcanti et. Al. (2010), according to recommendations of Mendes (2012), that in its Model of Attention Chronic Conditions / MACC, which establishes strata of risks from 1 to 5. The analysis of the data occurred through the Statistical Package for the Social Sciences (SPSS) Version 22. This study was approved by opinion nº. 1,337,669 in compliance with the recommendations of Resolution nº. 466/2012 of the National Health Council (CNS). Sociodemographic results were 79% female, with an average age of 56.7 (± 11), 32% had incomplete elementary school, 24% were retired and had a family income of 75% from one to three minimum wages. Regarding clinical variables, life habits, 55% performed physical activity, 40% did not smoke or drink; Antecedents, 73% have arterial hypertension in the family, and 88% are hypertensive; On physical examination, 54% abnormal heart auscultation, and 58% did not perform physical examination of the feet. The Body Mass Index was 42% overweight, with 73% with Abdominal Circumference substantially increased. Blood pressure was altered by 46%. To the laboratory tests, 51% were with altered fasting glucose. The Fragmingham score had 47% scored at low risk. With the proposed general objective, 38% were in Stratum 4, high risk, with complex chronic disease with capacity for self-care, with difficulty in adhering to treatment, injuries in other organs, but still able to develop their self care, Multiprofessional, that is, the same day and shift, going through all the professionals. This result corresponds to a high percentage of individuals who need a focused and multiprofessional attention in Primary Care, to prevent injuries and for secondary / tertiary referrals to be reduced and DM mortality avoided. Stratifying the risk that diabetes represents the individual according to his needs, will help the professional to improve the quality of the service to be offered to this population.

Astrocaryum aculeatum (Tucumã), is a native Amazon fruit rich in carotenoids and polyphenols. In this way, the present study aimed to obtain the fixed oil of Astrocaryum aculeatum and its genotoxic and/or antigenotoxic evaluation in vivo with acute treatment in Swiss mouse. The methodology was used, the fruit was dried, peeled and stored in a greenhouse for 50º per 24h and cooled by room temperature. The resulting mass was 28.21% of the total of the fruit, being subjected to hydraulic pressing, obtaining 22, 21% of the oil. Animals (males - 6 per group) were used to gavage the oil at concentrations of 500, 1000 and 2000 mg / kg b.p. (Genotoxic groups); And Doxorubicin-DXR-associated intraperitoneally at the concentration of 15 mg / kg b.p. (Antigenotoxic groups). Dimethylsufoxide-DMSO, the solvent used, was evaluated in isolation to exclude possible influence on the results. All groups were analyzed from the laminae from smears with peripheral blood, which was collected 24h and 48h after the appropriate treatments, where 2000 cells per animal were analyzed. Results and Discussion: The genotoxic groups did not show statistically significant differences in relation to the negative control, and in relation to the antigenotoxic test there was a statistically significant difference for all the concentrations used in relation to the positive control group (DXR), with a significant reduction of about 36 , 57 ± 1.74% for treatments of 24h and 65,18 ± 1,29% for those of 48h, in the frequency of PCEMNs. Conclusion: The AA presented a relevant antigenotoxic effect, and no genotoxic effect, for all the concentrations used in both 24h and 48h.
Keywords: Astrocaryum aculeatum; Micronucleus; Tucumã; Genotoxicity.

Introduction: Type 2 diabetes mellitus is an acquired chronic disease related to the imbalance of glucose levels in the body due to lifestyle and environmental factors. Currently, this disorder is a challenge to public health because its complications affect the functionality of organs and tissues, including the eye, hampering the passage of blood and other nutrients to the retina, impairing metabolism and triggering morphological and functional changes in vision which reflect on chromatic and achromatic disorders. Objective: Evaluate the chromatic and achromatic vision in their morphological and functional aspects in people diagnosed with Type 2 Diabetes Mellitus. Methods: It was made a case-control study with a quantitative approach which evaluated 14 participants with type 2 diabetes mellitus with an average age of 57.435 ± 8.69 years old and compared to the control group evaluation results with an average age of 51, 66 ± 7.29. All participants underwent ophthalmic clinical evaluation consisting of refraction, assessment of intraocular pressure, retinography and optical coherence tomography (OCT). For comparison it was used 251.2 to 172.8 as normal range for the foveal thickness and 120.71 to 82.3 for the thickness of the optic nerve. Then the participants were submitted to a psychophysical evaluation through Lanthony D15 desaturated, Farnsworth-Munsell FM-100and the spatial luminance contrast sensitivity function-CSF. The results were tabulated in Microsoft Office Excel 2007 program and statistically analyzed by BioEstat 5.3 and D15 Analysis for MATLAB programs. The study was approved by the Research Ethics Committee of the Federal University of Amapá under the FR-278871/09 protocol. Results: The pre-clinical evaluation showed that participants had normal visual response in the Ishihara test. The ophthalmological evaluation showed that all participants had a visual acuity within the established parameters of 20/40 or better. No participant had intraocular pressure greater than 21mmHg. In the retinography no participant had a diagnosis of diabetic retinopathy and the OCT showed that the foveal thickness and the layer of optic nerve fibers presented changes of values and there were significant statistical correlation with glycated hemoglobin and blood glucose. The psychophysical evaluation showed that the visual performance of the group with T2DM was worse than the control group performance because there were statistical variations in Lanthony D15 desaturated related to the color confusion index, C-Index and S-Index. In the FM-100 test the spatial error exhibited statistical variance inthe control group. In the CSF test low and media frequencies showed greater variance in the control group as well. Conclusion: The findings show that changes in optical coherence tomography examinations were associated in at least one of the three psychophysical tests used in this study, so it is possible to conclude that morphological damage tends to impair functional. We also emphasize the presence of functional losses, even if we did not detect morphological alterations. In this way, we reinforced the importance of psychophysical tests in the monitoring of the functional capacity of the visual system, before the lesions were installed.

Keywords: Type 2 Diabetes Mellitus, Psychophysics, Vision, Optical Coherence Tomography.

A construção de usinas hidrelétricas faz parte de um cenário de mudanças provocadas pelo ser humano em busca da produção de energia e têm se encontrado no centro de discussões pelo Brasil e pelo mundo. Nas últimas décadas essas construções passaram a se concentrar na Amazônia tendo em vista o grande potencial de geração de energia hidrelétrica na região. O Estado do Amapá faz parte deste panorama amazônico de grandes projetos hidroelétricos onde além das fontes geradoras que já operam, outras mais têm se instalado. Assim o objetivo desta pesquisa é identificar os impactos causados pela Hidrelétrica Cachoeira Caldeirão, no perfil epidemiológico da população do município de Porto Grande e como pode influenciar na epidemiologia da Leishmaniose Tegumentar Americana (LTA). A área escolhida para desenvolver o estudo foi o município de Porto Grande, localizado a 103 km de Macapá, capital do Estado, que abrigará a Usina juntamente com o município vizinho, Ferreira Gomes. Para alcançar o objetivo que este trabalho propõe foi analisada a fase inicial do processo de implantação da usina que engloba o desmatamento e suas repercussões na saúde. Três bairros foram identificados com maior número de casos da doença, o que levou a definição de que para cada um deveria existir uma amostra mínima de 10% com auxílio dos setores censitários do Instituto Brasileiro de Geografia e Estatística (IBGE). Com base nos formulários e no Sistema de Notificação Nacional foi possível delimitar o perfil da população acometida pela doença nos arredores da usina, percebendo-se que em sua maioria são homens (80,62%) em idade de 20 a 39 anos (50,12%) e pardos (78,55%). Os dados obtidos através dos formulários não confirmaram a hipótese de que o aumento de casos da LTA no SINAN seria resultado da influência da UHE Cachoeira Caldeirão, tendo em vista que as residências com casos da doença eram de indivíduos que adquiriram em anos anteriores a 2009. Considerando a escassez de estudos com a temática no Amapá, esta pesquisa se faz de extrema relevância afim de entender a LTA e sua relação com grandes impactos ambientais. 

Objetivo: Verificar os efeitos do treinamento funcional na aptidão física de mulheres idosas, na cidade de Macapá-AP. Métodos: A amostra contou com 27 mulheres regularmente matriculadas no projeto Universidade da Maturidade do Amapá (UMAP), com idade superior ou igual a 60 anos, sedentárias e independentes no desempenho das atividades instrumentais de vida diária. As voluntárias foram submetidas a um programa de treino funcional, realizado três vezes por semana, durante três meses. Ao final de cada mês de intervenção as voluntárias foram avaliadas através da bateria de testes de Rikli & Jones, bem como no 30o dia após o encerramento do programa. Resultados: Após doze semanas de treino funcional as idosas apresentaram um acréscimo de 113% (p<0,01) na força muscular de MMII, 95,16% (p<0,01) na força muscular de MMSS, 315,2% (p<0,01) na flexibilidade de MMII, 99,2% (p<0,05) na flexibilidade de MMSS; 34,4% (p<0,01) na mobilidade, e 191,8% (p<0,01) na capacidade aeróbia. Todavia, não foi observado mudanças significativas na composição corporal (p= 0,72). Após um período de quatro semanas de destreino, as idosas apresentaram queda significativa das habilidades, principalmente: flexibilidade de membros superiores (245,16% (p<0,01) e mobilidade 18,37% (p<0,0001), não apresentando alteração significativa na composição corporal (0,28%, p<0,72). Considerações finais: Um programa de três meses de TF se mostrou capaz de alterar de forma significativamente positiva habilidades da aptidão física de idosas, como flexibilidade de membros superiores e membros inferiores, capacidade aeróbica, força muscular de MMSS e MMII, e mobilidade, podendo diminuir as repercussões negativas do envelhecimento sobre a independência das idosas. Todavia um período de quatro semanas foi suficiente para ocasionar decréscimos importantes nos ganhos feitos com o programa de TF, principalmente na flexibilidade de MMSS.

Parasitism is the association between living things in which there is a unilateral benefits and intestinal parasites still represent a serious public health problem due to its high prevalence in the population. The lack of data on it is an aggravating factor, it is not known the situation of the problem and the knowledge of the reality in which a community is present, it is essential to define the actions to be implemented. This research makes a characterization and analysis of parasitic infections of patients seen in a clinic in Macapá, in order to identify the occurrence of enteroparasitosis of importance in public health in users treated at the unit, from January to December 2014. For this purpose, we analyzed the 2,817 files results of parasitological stool tests done at the clinic under study. The total of patients who underwent the tests 68.5% (1,929) were female and 31.3% (881) were male, as a result of the 1,694 tested positive for some type of intestinal parasite and 1123 the result was negative. Since the protozoa had the highest occurrence that helminths. The parasites occurred as follows: E. Protozoa with nails (23.3%), G. lamblia (19.8%), E. coli (14.8%), E. histolytica (9.3%), B. hominis (7.6%), I. butschlii (6.8%) and C. mesnilli (6.5%); and helminths with A. lumbricoides (5.9%), E. vermicularis (3.0%), T. trichiura (2.3%), Hookworms (0.3%) and finally S. stercoralis (0 , 2%). This result that the observation of the aspects analyzed the high enteroparasitosis index can be an immediate impact on factors such as the health and social conditions involving employment, income and education of the population served in the UBS Lélio Silva, located in Novo Buritizal neighborhood, which are still lacking these conditions in various regions of the capital Macapá, which must be distributed equitably, based on models of primary prevention and improving people's quality of life

ABSTRACT
The Culicidae are given special attention due to its blood-sucking habits, through which become
important disease vectors, which is indeed a serious reality in the Amazon. They belong to the
order Diptera, suborder Nematocera and Culicidae family. This study aimed to know the
richness, abundance and some ecological aspects of Culicidae assemblies of medical importance,
gallery forest and savanna vegetation types in morphoclimatic domain Amazonian Cerrado, the
hangover of community Quarry, Macapa, Amapá. The study area is characterized as
morphoclimatic domain with Amazon Cerrado savanna vegetation types and gallery forest,
located in the undertow of community Quarry Km 25 of Highway 70 AP, District of Pedreira,
municipality Macapa. The adult Culicidae collections were made in 2013 (May, August and
November) and 2014 (February and April), covering the periods of high and low rainfall
observed in the biennium. The sampling effort consisted of 75 hours for samples via active search
and 180 h with light traps CDC, a total effort of 255h. Mosquitoes specimens collected in the
field were stored in plastic cups properly labeled with information environments and schedules
shots and packed in Styrofoam boxes 20L, carried the Arthropoda Laboratory / UNIFAP for
taxonomic identification procedures and estimation of the ecological indexes. We sampled 1025
specimens of Culicidae with a wealth of S = 22 species belonging to 08 genera, subfamilies
Anophelinae N = 56 (5.46%) and Culicinae N = 969 (94.53%) and the tribes Anophelini N = 56 (
5,46%) N = 90 Aedeomyiini (8.78%), N Aedini = 438 (42,73%), Culicini N = 180 (17,56%),
Mansoniini N = 219 (21,36%) Sabethini N = 42 (4.09%). The areas under study offer
epidemiological risks related to transmission of arboviruses, Silvestre Yellow Fever, Malaria and
encephalitis.
Keywords: Culicidae. Mosquitoes. Vetors. Arboviruses.

Este trabalho tem como objetivo compreender a relação entre práticas corporais cotidianas e saúde, interpretando, do ponto de vista antropológico, visto que cada grupo interage com o ambiente que o cerca e a sua cultura define como viver nesse ambiente físico, sendo a esta responsável pela transformação dessas ações, que são expressas através de linguagens, entre elas a corporal. O corpo é uma síntese desta cultura, porque expressa elementos específicos da sociedade da qual faz parte e o homem vai assimilando e se apropriando dos valores, normas e costumes sociais através dele. A pesquisa em questão foi realizada na Comunidade Igarapé do Samaúma em Mazagão baseando-se na perspectiva da bricolagem que propõe o entrelaçamento de diversos métodos a fim de possibilitar uma leitura mais ampla da situação encontrada no contexto em questão, sendo realizado o contato inicial com a comunidade através de seus representantes, a inserção ecológica tendo sido feito registros sobre as práticas corporais cotidianas através de diário de campo, além de registros fotográficos e aplicadas entrevistas para compor a bricolagem de métodos. No contexto em questão a saúde é percebida como sinônimo de vida com qualidade, sem doenças, sem dores, fato observado principalmente na fala dos moradores da comunidade. O cuidado com a saúde é percebido principalmente através da alimentação, descanso e práticas corporais. Porém, quando observamos o contexto local das práticas corporais é possível notar a influência da tecnologia em relação a estas práticas, como no caso da presença de motores na maioria dos barcos, no lugar de remos entre outros equipamentos, substituindo a cada dia o contato do homem com o meio em que vive, e em consequência, as próprias práticas corporais. Este contexto está em constante modificação de sua cultura devido ao intenso contato com município de contexto urbano, a chegada da energia elétrica e com ela aparelhos como a televisão, que é um veículo de informações de massa, e estas modificações acabam por substituir atividades como o banho de rio. Diante destes resultados verifica-se que é necessário incentivar a valorização da cultura ribeirinha, além de promover ações educativas em relação às praticas corporais relacionadas à saúde.

ABSTRACT
Drug treatment for tuberculosis (TB) include neurotoxic drugs such as isoniazid and ethambutol, which admittedly can cause optic neuritis retrobulbar. The inflammatory process can lead to different changes in visual function. The study aimed to assess color vision and contrast sensitivity in spatial luminance TB patients at diagnosis, during treatment (15, 30 and 60 days) and after treatment of the intensive phase of TB (90 days). We tested 30 participants (63 eyes), 20 men and 10 women with TB, with a mean age (51 ± 15 years) and compared to the control group. For the assessment of color vision testing were used Spatial Color of Farnworth-Munsell 100-FM-test and the Contrast Sensitivity Function Space Luminance-FSCL (n = 63 eyes). The results of the patients were compared with 1.96 standard deviation of the mean of the control group (error = 63.73). The comparison between groups showed that there was significant difference between groups (two-way ANOVA measures p <.05). Before treatment no patient presented above error to the reference value. The average error increased FM-100 with the beginning of the treatment and reached the peak at 60 days after initiation of treatment. After completion of treatment (> 90 days) error values decreased, but still had not returned to control levels. The control group also showed good sensitivity to spatial contrast luminance higher than those obtained by the group of treated subjects who presented with 15 days and evolved in groups of 30 and 40 to 45 days, showed that the peak of impaired contrast sensitivity space in most spatial frequencies, especially at frequencies 0.2 to 10 cpd. For groups that are made use of ethambutol: group (0 days) did not differ from the control group and the group (90 days) performed better sensitivity than the groups who used the medication. TB patients had poorer performance than the untreated subjects in the test FM-100 and FSCL with a peak at 60 days after initiation of treatment and 90 days after partial reversibility.
Keywords: Tuberculosis, Colors vision, Visual Changes, Visual Psychophysics.

HEPATITE VIRAL C: GENOTIPAGEM NOS USUÁRIOS ATENDIDOS NO CENTRO DE REFERÊNCIA DE DOENÇAS TROPICAIS DO ESTADO DO AMAPÁ.